ArticlePloS one2018
Prognostic utility of serum free light chain ratios and heavy-light chain ratios in multiple myeloma in three PETHEMA/GEM phase III clinical trials.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Prognostic Impact of the Hevylite Assay in Patients With IgG or IgA Multiple Myeloma Treated Within the GMMG-MM5 Trial.European journal of haematology · 2026Article
- Protein Misfolding and Aggregation of Pathological IgG Light Chains in Oncohematological Dyscrasias: From Molecular Pathways to Clinical Implications.Current protein & peptide science · 2025Review
- Role of serum-free light chain assay for defining response and progression in immunoglobulin secretory multiple myeloma.American journal of hematology · 2022Article
- Serum Free Light-Chain Ratio at Diagnosis Is Associated with Early Renal Damage in Multiple Myeloma: A Case Series Real-World Study.Biomedicines · 2022Article
- The Current Role of the Heavy/Light Chain Assay in the Diagnosis, Prognosis and Monitoring of Multiple Myeloma: An Evidence-Based Approach.Diagnostics (Basel, Switzerland) · 2021Review
- Article
- Prognostic impact of rapid reduction of involved free light chains in multiple myeloma patients under first-line treatment with Bendamustine, Prednisone, and Bortezomib (BPV).Journal of cancer research and clinical oncology · 2021Article
- Quantification of measurable residual disease in patients with multiple myeloma based on the IMWG response criteria.Scientific reports · 2021Article
- Measurable residual disease in multiple myeloma: ready for clinical practice?Journal of hematology & oncology · 2020Review
- Utility of serum free light chain ratio in response definition in patients with multiple myeloma.Blood advances · 2020Article
- The clinical significance of stringent complete response in multiple myeloma is surpassed by minimal residual disease measurements.PloS one · 2020Observational
- Serum Free Immunoglobulins Light Chains: A Common Feature of Common Variable Immunodeficiency?Frontiers in immunology · 2020Article
- Free Light Chains as a Novel Diagnostic Biomarker of Immune System Abnormalities in Multiple Sclerosis and HIV Infection.BioMed research international · 2019Review
Corrections and comments
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Authors and funding
27 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We investigated the prognostic impact and clinical utility of serum free light chains (sFLC) and serum heavy-light chains (sHLC) in patients with multiple myeloma treated according to the GEM2005MENOS65, GEM2005MAS65, and GEM2010MAS65 PETHEMA/GEM phase III clinical trials. Serum samples collected at diagnosis were retrospectively analyzed for sFLC (n = 623) and sHLC (n = 183). After induction or autologous transplantation, 309 and 89 samples respectively were available for sFLC and sHLC assays. At diagnosis, a highly abnormal (HA) sFLC ratio (sFLCr) (<0.03 or >32) was not associated with higher risk of progression. After therapy, persistence of involved-sFLC levels >100 mg/L implied worse survival (overall survival [OS], P = 0.03; progression-free survival [PFS], P = 0.007). Among patients that achieved a complete response, sFLCr normalization did not necessarily indicate a higher quality response. We conducted sHLC investigations for IgG and IgA MM. Absolute sHLC values were correlated with monoclonal protein levels measured with serum protein electrophoresis. At diagnosis, HA-sHLCrs (<0.29 or >73) showed a higher risk of progression (P = 0.006). Additionally, involved-sHLC levels >5 g/L after treatment were associated with shorter survival (OS, P = 0.001; PFS, P = 0.018). The HA-sHLCr could have prognostic value at diagnosis; absolute values of involved-sFLC >100 mg/L and involved-sHLC >5 g/L could have prognostic value after treatment.
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