title: Serum free light chain response after 2 courses of induction chemotherapy predicts prognosis in myeloma patients.
abstract: BACKGROUND
  The aim of this study was to investigate the prognostic effect of serum free light chain (sFLC) response after 2 cycles of first-line chemotherapy (CT) in multiple myeloma (MM) patients.
  
  
  METHODS
  The data of 78 newly diagnosed MM patients who had sFLC levels at diagnosis and after 2 cycles of first-line CT were included in the study. The prognostic effect of sFLCs were evaluated with normalization of sFLC κ/λ ratio after 2 cycles of CT and involved/uninvolved (i/u) sFLCs.
  
  
  RESULTS
  At the end of follow-up the probability of overall survival (OS) was 95.7% versus 68.5% in patients with and without normalized sFLC κ/λ ratio, respectively (P = .072). The probability of OS with i/u sFLC assessment was 97.4% versus 55.8% with regard to i/u sFLC ≤ 10 and > 10, respectively (P = .001). In univariate and multivariate analysis including sFLC ratio, age, sex, and International Staging System, i/u sFLC ratio > 10 after 2 cycles of CT was identified as an independent risk factor for OS (P = .015; hazard ratio [HR], 13.2; 95% confidence interval [CI], 1.668-104.65 vs. P = .011; HR, 15.17; 95% CI, 1.85-123.89).
  
  
  CONCLUSIONS
  Early response assessment in terms of sFLC after 2 courses of induction CT seems to have a prognostic effect in MM patients. The methodology and timing of the evaluation based on sFLCs needs to be validated in prospective studies.
authors.affiliation: Gazi University, Faculty of Medicine, Department of Hematology, Ankara, Turkey. Electronic address: ayagci@gazi.edu.tr.
authors.forename: Münci
authors.initials: M
authors.lastname: Yağcı
authors.affiliation: Gazi University, Faculty of Medicine, Department of Hematology, Ankara, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Karakaya
authors.affiliation: Gazi University, Faculty of Medicine, Department of Hematology, Ankara, Turkey.
authors.forename: Elif
authors.initials: E
authors.lastname: Suyanı
authors.affiliation: Gazi University, Faculty of Medicine, Department of Hematology, Ankara, Turkey.
authors.forename: Rauf
authors.initials: R
authors.lastname: Haznedar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D005260:Female; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000097:blood*; D060828:Induction Chemotherapy; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood* / Q000188:drug therapy*; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor; D007147:Immunoglobulin Light Chains
keywords: Multiple myeloma; Overall survival (OS); Response; Therapy; Treatment