Hevylite ®

They measure both the involved (clonal) and the uninvolved (non-clonal) immunoglobulin. This gives unique and useful prognostic information about immune suppression of the uninvolved isotype e.g. IgAλ in an IgAκ patient.

The assays generate numerical results for:

• IgGκ, IgGλ and IgGκ/IgGλ ratio
• IgAκ, IgAλ and IgAκ/IgAλ ratio
• IgMκ, IgMλ and IgMκ/IgMλ ratio

Hevylite is useful to:

• Accurately quantify monoclonal proteins at low levels (<10 g/L)
• Identify residual disease in Multiple Myeloma
• Detect Multiple Myeloma relapse earlier than traditional testing
• Provide optimal monitoring alongside Freelite (incl. clonal change: at relapse, a different clone may emerge to the clone seen at the diagnosis)

Test results

The Hevylite assays individually measure IgGκ, IgGλ, IgAκ, IgAλ, IgMκ and IgMλ in g/L.

Term	Definition	Description	Example in an IgGk MM patient
HLC	Heavy and light chain isotypes
iHLC	Involved HLC	The HLC type produced by the tumour. Measures monoclonal production	IgGκ
uHLC	Uninvolved HLC	Measures polyclonal production	IgGλ
HLC ratio	e.g. IgAκ/IgAλ	Indicates clonality	IgGκ/IgGλ
dHLC	iHLC – uHLC	For a particular immunoglobulin isotype, the difference in concentration between the iHLC and uHLC	IgGκ-IgGλ
HLC-pair suppression	Only uHLC is below normal reference interval	The ratio must be abnormal	Suppression of IgGλ

A Laboratory Overview

Hevylite is a quick, simple and highly sensitive laboratory serum test for measuring intact immunoglobulin monoclonal proteins. It identifies and measures IgGκ, IgGλ, IgAκ, IgAλ, IgMκ and IgMλ individually. These proteins are assessed in pairs, e.g. IgGκ/IgGλ, to produce ratios.

Benefits of Hevylite:

• provides greater sensitivity than electrophoretic methods, e.g. below 10 g/L monoclonal protein
• overcomes technical challenges observed with electrophoresis such as co-migration, non-linearity and dye saturation
• maximizes workflow through automation and reduces “hands-on” time
• provides quantitative results and avoids subjective interpretation of gels
• reduces the number of different tests needed to get a result, especially for IgA monoclonal proteins

Hevylite Assay Menu and Kits

Optilite

Kit	Product Code	Kit size	Measuring Range	Sample Type
Hevylite IgAκ	NK623.OPT	50 tests	0.018 – 112g/L	Serum, plasma
Hevylite IgAλ	NK624.OPT	50 tests	0.016 – 104g/L	Serum, plasma
Hevylite IgMκ	NK625.OPT	50 tests	0.02 – 150g/L	Serum, plasma
Hevylite IgMλ	NK626.OPT	50 tests	0.018 – 135g/L	Serum, plasma
Hevylite IgGκ	NK621.OPT	50 tests	0.115 – 120g/L	Serum, plasma
Hevylite IgGλ	NK622.OPT	50 tests	0.075 – 105g/L	Serum, plasma

Clinical laboratory practice

• Using both Freelite and Hevylite tests during monitoring allows light chain and intact immunoglobulin clones to be detected, giving clinicians more and earlier information.
• IMWG MRD Guidelines now include Hevylite