Unusual thermal transition in the serum calorimetric profile of a patient diagnosed with multiple myeloma with secretion of monoclonal κ free light chains: a case report

What is it about?

Abstract Differential scanning calorimetry (DSC) gains speed and success in the last decade in the characterization of blood plasma and serum. Numerous publications reveal the potential of this technique to identify calorimetric markers specific for variety of diseases and their staging. In our previous works we have clearly demonstrated that DSC can serve to classify multiple myeloma cases in a number of calorimetric groups whose thermodynamic parameters are strongly affected by the level and isotype of the secreted monoclonal immunoglobulins or free light chains (FLC). In this report we present a case of multiple myeloma with secretion of monoclonal κ FLC (stage III according to ISS classification). High FLC level (about 20% from the total protein content) was found in the patient’s serum that remained persistent for the monitoring period of 1 year. The calorimetric profile of the serum revealed the occurrence of an unusual calorimetric transition at 46-47 °C, unique among nearly 500 multiple myeloma patients studied by us so far. This transition was assigned to unstable monoclonal free light chains that also led to the formation of amorphous aggregates (imaged by atomic force microscopy) in the patient’s serum. Additional studies of patients with similar calorimetric features are needed in order to relate the emergence of the 47 °C transition and protein aggregation to the disease activity status of multiple myeloma or to other pathology.

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