Serum free light chain ratio as a biomarker for high-risk smoldering multiple myeloma

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 p...

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Veröffentlicht in:Leukemia 2013-04, Vol.27 (4), p.941-946
Hauptverfasser: Larsen, J T, Kumar, S K, Dispenzieri, A, Kyle, R A, Katzmann, J A, Rajkumar, S V
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container_issue 4
container_start_page 941
container_title Leukemia
container_volume 27
creator Larsen, J T
Kumar, S K
Dispenzieri, A
Kyle, R A
Katzmann, J A
Rajkumar, S V
description 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
doi_str_mv 10.1038/leu.2012.296
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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.</description><subject>692/699/67/1857</subject><subject>692/699/67/1990/804</subject><subject>692/700/1750</subject><subject>Amyloidosis</subject><subject>Anemia</subject><subject>Asymptomatic</subject><subject>Biological markers</subject><subject>Biomarkers</subject><subject>Biomarkers, Tumor - blood</subject><subject>Cancer Research</subject><subject>Care and treatment</subject><subject>Chains</subject><subject>Critical Care Medicine</subject><subject>Diagnosis</subject><subject>Female</subject><subject>Hematology</subject><subject>Humans</subject><subject>Hypercalcemia</subject><subject>Immunoglobulin Light Chains - blood</subject><subject>Intensive</subject><subject>Internal Medicine</subject><subject>Leukemia</subject><subject>Light</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical records</subject><subject>Medicine</subject><subject>Medicine &amp; 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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 &lt;100 group ( P &lt;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.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>23183428</pmid><doi>10.1038/leu.2012.296</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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subjects 692/699/67/1857
692/699/67/1990/804
692/700/1750
Amyloidosis
Anemia
Asymptomatic
Biological markers
Biomarkers
Biomarkers, Tumor - blood
Cancer Research
Care and treatment
Chains
Critical Care Medicine
Diagnosis
Female
Hematology
Humans
Hypercalcemia
Immunoglobulin Light Chains - blood
Intensive
Internal Medicine
Leukemia
Light
Male
Medical prognosis
Medical records
Medicine
Medicine & Public Health
Middle Aged
Multiple myeloma
Multiple Myeloma - blood
Multiple Myeloma - diagnosis
Oncology
original-article
Patients
Physiological aspects
Plasma
Proteins
Risk
ROC Curve
Sensitivity and Specificity
Smoldering
Subgroups
Working groups
title Serum free light chain ratio as a biomarker for high-risk smoldering multiple myeloma
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