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Alerted by two index cases with clinical impact due to failure of the FLC analysis to indicate a disease progression, we aimed to identify any clinical consequences due to known differences between FLC analysis methods. We applied two FLC analysis methods (Freelite Binding Site [FBS] and N\u2010Latex Siemens [NLS]) on all patients with MM and monoclonal gammopathy of uncertain significance diagnosed\/followed up at S\u00f6dra \u00c4lvsborg Hematology Unit, from April to December 2022. From a total of 123 patients with malignant plasma cell disorder, we identified five cases (4.1%) where solely the FBS method, as opposed to NLS, urine and serum electrophoresis, could support diagnosis or detect progression. The consequences of this discrepancy included not only change of diagnosis or delayed therapy but also change of treatment. Our findings indicate that a stronger awareness of the potential weaknesses of different FLC methods is needed, which calls for a closer collaboration between clinical chemists and hematologists.<\/jats:p>","DOI":"10.1002\/jha2.886","type":"journal-article","created":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T05:40:06Z","timestamp":1712727606000},"page":"455-461","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The choice of serum\u2010free light chain analysis method could potentially have clinical consequences for myeloma patients"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-0334-5282","authenticated-orcid":false,"given":"Ljupco","family":"Veskovski","sequence":"first","affiliation":[{"name":"Department of Research Education and Innovation and Department of Medicine (Hematology Unit) S\u00f6dra \u00c4lvsborg Hospital (S\u00c4S) Bor\u00e5s Region V\u00e4stra G\u00f6taland (VGR)  Boras Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingvar","family":"Jakobsson","sequence":"additional","affiliation":[{"name":"Laboratory for Clinical Chemistry S\u00c4S Bor\u00e5s and Department of Clinical Chemistry Sahlgrenska University Hospital  Goteborg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per\u2010Ola","family":"Andersson","sequence":"additional","affiliation":[{"name":"Department of Haematology Sahlgrenska University Hospital Goteborg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Therese","family":"Gustafsson","sequence":"additional","affiliation":[{"name":"Laboratory for Clinical Chemistry S\u00c4S Bor\u00e5s and Department of Clinical Chemistry Sahlgrenska University Hospital  Goteborg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annelie","family":"Sedigh","sequence":"additional","affiliation":[{"name":"Laboratory for Clinical Chemistry 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