Document Detail


Serum free light chain ratio as a biomarker for high-risk smoldering multiple myeloma.
MedLine Citation:
PMID:  23183428     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A markedly elevated serum free light chain (FLC) ratio may serve as a biomarker for malignant transformation in high-risk smoldering multiple myeloma (SMM) and identify patients who are at imminent risk of progression. We retrospectively studied the predictive value of the serum (FLC) assay in 586 patients with SMM diagnosed between 1970 to 2010. A serum involved/uninvolved FLC ratio ≥ 100 was used to define high-risk SMM, which included 15% (n=90) of the total cohort. Receiver operating characteristics analysis determined the optimal FLC ratio cut-point to predict progression to symptomatic multiple myeloma (MM) within 2 years of diagnosis, which resulted in a specificity of 97% and sensitivity of 16%. Fifty-six percent of patients developed progressive disease during median follow-up of 52 months, but this increased to 98% in the subgroup of patients with FLC ratio ≥ 100. The median time to progression in the FLC ratio ≥ 100 group was 15 months versus 55 months in the FLC <100 group (P<0.0001). The risk of progression to MM within the first 2 years in patients with an FLC ratio ≥ 100 was 72%; the risk of progression to MM or light chain amyloidosis in 2 years was 79%. We conclude that a high FLC ratio ≥ 100 is a predictor of imminent progression in SMM, and such patients may be considered candidates for early treatment intervention.
Authors:
J T Larsen; S K Kumar; A Dispenzieri; R A Kyle; J A Katzmann; S V Rajkumar
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-10-16
Journal Detail:
Title:  Leukemia     Volume:  27     ISSN:  1476-5551     ISO Abbreviation:  Leukemia     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-04-11     Completed Date:  2013-06-04     Revised Date:  2013-07-11    
Medline Journal Info:
Nlm Unique ID:  8704895     Medline TA:  Leukemia     Country:  England    
Other Details:
Languages:  eng     Pagination:  941-6     Citation Subset:  IM    
Affiliation:
Division of Hospital Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Female
Humans
Immunoglobulin Light Chains / blood*
Male
Middle Aged
Multiple Myeloma / blood*,  diagnosis
ROC Curve
Sensitivity and Specificity
Tumor Markers, Biological / blood*
Grant Support
ID/Acronym/Agency:
CA 100707/CA/NCI NIH HHS; CA 107476/CA/NCI NIH HHS; CA 62242/CA/NCI NIH HHS; CA 83724/CA/NCI NIH HHS; CA168762/CA/NCI NIH HHS; P01 CA062242/CA/NCI NIH HHS; P50 CA100707/CA/NCI NIH HHS; R01 CA083724/CA/NCI NIH HHS; R01 CA107476/CA/NCI NIH HHS; R01 CA168762/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Immunoglobulin Light Chains; 0/Tumor Markers, Biological
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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