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- Title
Prognostic value of the serum free light chain ratio in newly diagnosed myeloma: proposed incorporation into the international staging system.
- Authors
Snozek, C. L. H.; Katzmann, J. A.; Kyle, R. A.; Dispenzieri, A.; Larson, D. R.; Therneau, T. M.; Melton III, L. J.; Kumar, S.; Greipp, P. R.; Clark, R. J.; Rajkumar, S. V.; Melton, L J 3rd
- Abstract
To determine if the serum free light chain (FLC) ratio has prognostic value in patients with symptomatic multiple myeloma (MM), baseline serum samples from a well-characterized cohort of 790 newly diagnosed MM patients were tested with the FLC assay. FLC ratio was calculated as kappa/lambda (reference range 0.26-1.65). On the basis of the distribution of values, a cutpoint kappa/lambda FLC ratio of <0.03 or >32 was chosen for further analysis. Overall survival was significantly inferior in patients with an abnormal FLC ratio of <0.03 or >32 (n=479) compared with those with an FLC ratio between 0.03 and 32 (n=311), with median survival of 30 versus 39 months, respectively. We incorporated abnormal FLC ratio with the International Staging System (ISS) risk factors (that is, albumin <3.5 g/dl and serum beta(2)-microglobulin >or=3.5 g/l), to create a risk stratification model with improved prognostic capabilities. Patients with 0, 1, 2 or 3 adverse risk factors had significantly different overall survival, with median survival times of 51, 39, 30 and 22 months, respectively (P<0.001). These findings suggest that the serum FLC ratio at initial diagnosis is an important predictor of prognosis in myeloma, and can be incorporated into the ISS for improved risk stratification.
- Subjects
PROGNOSIS; MULTIPLE myeloma treatment; B cell lymphoma; BLOOD plasma; SERODIAGNOSIS
- Publication
Leukemia (08876924), 2008, Vol 22, Issue 10, p1933
- ISSN
0887-6924
- Publication type
journal article
- DOI
10.1038/leu.2008.171