title: Presence of monoclonal free light chains in the serum predicts risk of progression in monoclonal gammopathy of undetermined significance.
abstract: We hypothesized that the presence of monoclonal free light chains (FLC) in the serum of patients with monoclonal gammopathy of undetermined significance (MGUS) is a marker of clonal evolution and a risk factor for progression. Forty-seven patients with MGUS and documented progression to myeloma or related malignancy were compared with 50 age- and gender-matched patients with MGUS and no evidence of progression after 5 or more years of follow-up. The presence of an abnormal kappa/lambda FLC ratio in the serum was associated with a higher risk of MGUS progression (relative risk 2.5; 95% confidence interval: 1.6-4.0; P < 0.001).
authors.affiliation: Division of Hematology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. rajks@mayo.edu
authors.forename: S Vincent
authors.initials: SV
authors.lastname: Rajkumar
authors.forename: Robert A
authors.initials: RA
authors.lastname: Kyle
authors.forename: Terry M
authors.initials: TM
authors.lastname: Therneau
authors.forename: Raynell J
authors.initials: RJ
authors.lastname: Clark
authors.forename: Arthur R
authors.initials: AR
authors.lastname: Bradwell
authors.forename: L Joseph
authors.initials: LJ
authors.lastname: Melton
authors.forename: Dirk R
authors.initials: DR
authors.lastname: Larson
authors.forename: Matthew F
authors.initials: MF
authors.lastname: Plevak
authors.forename: Jerry A
authors.initials: JA
authors.lastname: Katzmann
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D016022:Case-Control Studies; D018450:Disease Progression; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000097:blood*; D007145:Immunoglobulin kappa-Chains / Q000097:blood; D007146:Immunoglobulin lambda-Chains / Q000097:blood; D010265:Paraproteinemias / Q000097:blood*; D011379:Prognosis
chemical_list: D014408:Biomarkers, Tumor; D007147:Immunoglobulin Light Chains; D007145:Immunoglobulin kappa-Chains; D007146:Immunoglobulin lambda-Chains