ArticleLeukemia2013
Serum free light chain ratio as a biomarker for high-risk smoldering multiple myeloma.
Article in Leukemia, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 88 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Diagnostic Screening Trial Seeking AL Amyloidosis Very Early
Screening to Improve Survival in AL Amyloidosis
Screening for AL Amyloidosis in Smoldering Multiple Myeloma
Who cites it
88 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Early versus deferred treatment for smoldering multiple myeloma: a meta-analysis of randomized, controlled trials.PloS one · 2014Pooled it
- Trial
- Clinical outcomes of newly diagnosed myeloma patients with SLIM criteria : a subgroup analysis of the CASSIOPEIA study.Leukemia · 2026Article
- Smoldering multiple myeloma: advances in diagnosis and risk stratification, and evolving therapeutic strategies.International journal of hematology · 2026Review
- A multicenter study of progression risk and outcomes in solitary bone plasmacytoma with and without marrow involvement.Blood advances · 2026Article
- Serum free light chain concentration and ratio-based criterion for myeloma-defining event, in its current version, is untenable.British journal of haematology · 2026Review
- Primum non nocere: a critical analysis of early intervention clinical trials in smoldering multiple myeloma.Frontiers in oncology · 2026Review
- Navigating the evolving management of smoldering multiple myeloma.HemaSphere · 2026Review
- Article
- Serum and Tissue Light-Chains as Disease Biomarkers in AL Amyloidosis.International journal of molecular sciences · 2025Review
- Performance and comparison of FLCCheck: a novel serum free light chain assay for the Auxiliary Diagnosis of Multiple Myeloma.European journal of medical research · 2025Article
- Screening for monoclonal gammopathy of undetermined significance is contraindicated.British journal of haematology · 2025Review
- Evaluating serum free light chain ratio as a biomarker in multiple myeloma.Haematologica · 2025Article
- Smoldering multiple myeloma: Integrating biology and risk into management.Seminars in hematology · 2025Review
- Autologous stem cell transplantation for multiple myeloma patients whose myeloma-defining event was SLiM.British journal of haematology · 2025Article
- A Novel Strategy for Assessing Bone Marrow Plasma Cell Percentage: Development and Internal Validation of a Surrogate Calculation Approach.Advances in hematology · 2025Article
- Performance Characteristics and Limitations of the Available Assays for the Detection and Quantitation of Monoclonal Free Light Chains and New Emerging Methodologies.Antibodies (Basel, Switzerland) · 2024Review
- An overview of multiple myeloma: A monoclonal plasma cell malignancy's diagnosis, management, and treatment modalities.Saudi journal of biological sciences · 2024Review
- Breaking through Multiple Myeloma: A Paradigm for a Comprehensive Tumor Ecosystem Targeting.Biomedicines · 2023Review
- SLiM CRAB criteria revisited: temporal trends in prognosis of patients with smoldering multiple myeloma who meet the definition of 'biomarker-defined early multiple myeloma'-a systematic review with meta-analysis.EClinicalMedicine · 2023Article
28 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
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.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.