title: Free light chains ratio as a marker to estimate prognosis and survival in patients with multiple myeloma and primary amyloidosis.
abstract: OBJECTIVE
  The aim of this study was to evaluate the significance of free light chains ratio (FLC ratio) as a prognostic factor for remission, progression and survival in patients with multiple myeloma (MM) and primary amyloidosis.
  
  
  METHODS
  The concentrations of immunoglobulins and FLC ratio were measured using immunonephelometry. A total of 101 patients from 3 different disease groups were investigated during a 7-year period: 1) MM (n=95); 2) nonsecretory multiple myeloma (NSMM) (n=3); and 3) primary amyloidosis (n=3). Reference range for FLC ratio was 0.26-1.65.
  
  
  RESULTS
  According to the International Staging System (ISS) for MM, abnormal serum FLC ratio was < 0.03 or > 32. Patients with MM and highly or intermediately abnormal FLC ratio and a combination of adverse risk factors (56.9%) had median survival of 26 months (range 16-38), as opposed to patients with normal or slightly changed values of FLC ratio without adverse risk factors (43.1%) with median survival of 45 months (range 27-69). Also, all of the patients with NSMM had slightly changed values of FLC ratio corresponding to low risk of disease progression. In patients with primary amyloidosis, 33.3% had slightly changed values of FLC ratio corresponding to low risk of disease progression, as opposed to 66.7% with abnormal FLC ratio, corresponding to high risk.
  
  
  CONCLUSIONS
  Abnormal FLC ratio in the examined groups could be an independent risk factor of disease progression and worse prognosis.
authors.affiliation: Institute of Research and Development, STADA Arzneimittel AG Hemofarm A.D., Belgrade, Serbia. veradovic@beotel.rs
authors.forename: V
authors.initials: V
authors.lastname: Radovic
authors.forename: Z
authors.initials: Z
authors.lastname: Mijuskovic
authors.forename: Lj
authors.initials: Lj
authors.lastname: Tukic
authors.forename: P
authors.initials: P
authors.lastname: Djurdjevic
authors.forename: J
authors.initials: J
authors.lastname: Stojanovic
authors.forename: M
authors.initials: M
authors.lastname: Zlatkovic
mesh_terms: D000686:Amyloidosis / Q000276:immunology / Q000401:mortality*; D015415:Biomarkers; D018450:Disease Progression; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000097:blood*; D000075363:Immunoglobulin Light-chain Amyloidosis; D009101:Multiple Myeloma / Q000276:immunology / Q000401:mortality*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D007147:Immunoglobulin Light Chains