ArticleBlood cancer journal2024
Progression free survival of myeloma patients who become IFE-negative correlates with the detection of residual monoclonal free light chain (FLC) by mass spectrometry.
Article in Blood cancer journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Mass spectrometry-based proteomics and metabolomics in multiple myeloma: a systematic review of prognostic biomarkers and minimal residual disease monitoring.Frontiers in medicine · 2026Pooled it
- Free Light Chain Monomer-Dimer Pattern Analysis as Non-Invasive Tool in Predicting MGUS and SMM Progression.Cancers · 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
- Clinical applications of mass spectrometry in multiple myeloma.Blood advances · 2025Review
- Review
- Automated detection of free monoclonal light chains by enhanced-sensitivity modified immunofixation electrophoresis with antisera against free light chains.Laboratory medicine · 2025Article
- [A protein-specific quantitative detection method based on polyacrylamide gel electrophoresis and online fluorescence imaging].Se pu = Chinese journal of chromatography · 2025Article
- EHA-EMN Evidence-Based Guidelines for diagnosis, treatment and follow-up of patients with multiple myeloma.Nature reviews. Clinical oncology · 2025Review
- Screening for monoclonal gammopathy of undetermined significance is contraindicated.British journal of haematology · 2025Review
- Monoclonal immunoglobulin measurement by mass spectrometry in patients with multiple myeloma and kidney failure: Analysis from the EuLITE trial.British journal of haematology · 2025Article
Corrections and comments
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Authors and funding
14 authors at 7 institutions in 2 countries.
Funding
Abstract
Deeper responses are associated with improved survival in patients being treated for myeloma. However, the sensitivity of the current blood-based assays is limited. Historical studies suggested that normalisation of the serum free light chain (FLC) ratio in patients who were negative by immunofixation electrophoresis (IFE) was associated with improved outcomes. However, recently this has been called into question. Mass spectrometry (MS)-based FLC assessments may offer a superior methodology for the detection of monoclonal FLC due to greater sensitivity. To test this hypothesis, all available samples from patients who were IFE negative after treatment with carfilzomib and lenalidomide-based induction and autologous stem cell transplantation (ASCT) in the Myeloma XI trial underwent FLC-MS testing. FLC-MS response assessments from post-induction, day+100 post-ASCT and six months post-maintenance randomisation were compared to serum FLC assay results. Almost 40% of patients had discordant results and 28.7% of patients with a normal FLC ratio had residual monoclonal FLC detectable by FLC-MS. FLC-MS positivity was associated with reduced progression-free survival (PFS) but an abnormal FLC ratio was not. This study demonstrates that FLC-MS provides a superior methodology for the detection of residual monoclonal FLC with FLC-MS positivity identifying IFE-negative patients who are at higher risk of early progression.
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Registered trials
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