Significance of serum free light chain ratio for prognosis of newly diagnosed multiple myeloma

Wanting Qiang; Tiancheng Luo; Jing LU; Jie HE; Lu LI; Rong LI; Xiaomei Chen; Yunyang Zhao; Hua Jiang; Weijun FU; Juan DU

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Significance of serum free light chain ratio for prognosis of newly diagnosed multiple myeloma

VernacularTitle:血清游离轻链比值对初诊多发性骨髓瘤的预后评估价值
Author: Wanting QIANG ^{1
,

2} ; Tiancheng LUO ^{1
,

2} ; Jing LU ^{1
,

2} ; Jie HE ^{1
,

2} ; Lu LI ^{1
,

2} ; Rong LI ^{1
,

2} ; Xiaomei CHEN ^{1
,

2} ; Yunyang ZHAO ^{1
,

2} ; Hua JIANG ^{1
,

2} ; Weijun FU ^{1
,

2} ; Juan DU ^{1
,

2}
Author Information

1. Department of Hematology, The Myeloma &
2. Lymphoma Center, Changzheng Hospital, Second Military Medical University
Publication Type:Journal Article
Keywords: serum free light chain; serum free light chain ratio; multiple myeloma; prognosis
From: Chinese Journal of Clinical Laboratory Science 2019;37(11):848-852
CountryChina
Language:Chinese
Abstract: Objective:To analyze the significance of serum free light chain (sFLC) for the prognosis of the patients with newly diagnosed multiple myeloma (NDMM).
Methods:The clinical data of 621 NDMM patients in Changzheng Hospital from June 2010 to December 2016 was retrospectively analyzed. The serum free light chain levels were measured and the ratios of κ/λ chains were calculated. The significance of serum free light chain ratio (sFLCR) for the prognosis of NDMM patients was analyzed.
Results:Among the 621 NDMM patients, 42 patients (6.8%) were in the normal free light chain ratio group (0.26≤sFLCR≤1.65), 247 patients (39.8%) were in the low free light chain ratio group (0.01＜sFLCR＜0.26 or 1.65＜sFLCR＜100), and 332 patients (53.5%) were in the high free light chain ratio group (sFLCR≤0.01 or sFLCR≥100). Compared with normal sFLCR group, the abnormal sFLCR group showed low level of hemoglobin; elevated levels of bone marrow plasma cells, serum creatinine and β 2 -MG, and more patients were in DS stage Ⅲ and ISS stage Ⅲ with high risks of cytogenetics(all P＜0.05). The overall survival (OS) in the normal sFLCR group was significantly better than the abnormol sFLCR groups (not reached vs 58.7 months, P=0.043). Compared with the patients with both high sFLCR and low risks of cytogenetics, the patients with high sFLCR and high risks of cytogenetics showed shorter overall survival time (median OS time was 41.6 months vs 61.4 months, P=0.015).
Conclusion:The NDMM patients with significantly abnormal sFLCR may indicate more tumor load and higher aggressive progression. sFLCR should be an independent prognostic indicator for the outcome of multiple myeloma. The patients with high sFLCR and cytogenetic abnormalities, have worse prognosis than the others.