title: Serum Free Light Chain Assessment Early After Stem Cell Transplantation as a Prognostic Factor in Multiple Myeloma.
abstract: BACKGROUND
  Multiple myeloma is an incurable cancer commonly treated with stem cell transplantation (SCT). Response is traditionally evaluated 100 days after SCT, both to allow for hematopoietic reconstitution and due to immunoglobulins' long half-lives. Free light chains (FLC) have significantly shorter half-lives and may provide evidence of response or treatment failure earlier after SCT.
  
  
  METHODS
  We retrospectively studied 83 consecutive patients with multiple myeloma who underwent SCT and found 69 who had FLC measured 30 or 60 days after SCT. Using conventional FLC response criteria, we considered a patient to be at high risk for early relapse if he or she failed to experience a partial response by day 30 or 60.
  
  
  RESULTS
  After a median overall follow-up of only 335 days, these high-risk patients had significantly shorter progression-free survival (median, 98 vs. 335 days, P = .001) and overall survival (366 days vs. median not reached, P = .016).
  
  
  CONCLUSIONS
  Early FLC assessment either 1 or 2 months after SCT using standard FLC response criteria was able to identify a subset of patients at high risk of early relapse, and these patients may benefit from earlier interventions.
authors.affiliation: Multiple Myeloma Program, Mount Sinai School of Medicine, New York, NY.
authors.forename: Kevin
authors.initials: K
authors.lastname: Barley
authors.affiliation: Multiple Myeloma Program, Mount Sinai School of Medicine, New York, NY.
authors.forename: Sharon
authors.initials: S
authors.lastname: Tindle
authors.affiliation: Department of Health Evidence and Policy, Mount Sinai School of Medicine, New York, NY.
authors.forename: Emilia
authors.initials: E
authors.lastname: Bagiella
authors.affiliation: Multiple Myeloma Program, Mount Sinai School of Medicine, New York, NY.
authors.forename: Sundar
authors.initials: S
authors.lastname: Jagannath
authors.affiliation: Multiple Myeloma Program, Mount Sinai School of Medicine, New York, NY. Electronic address: ajai.chari@mountsinai.org.
authors.forename: Ajai
authors.initials: A
authors.lastname: Chari
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood* / Q000473:pathology*; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000379:methods; D019172:Transplantation Conditioning / Q000379:methods; D014182:Transplantation, Autologous / Q000379:methods
chemical_list: D007147:Immunoglobulin Light Chains
keywords: Autologous stem cell transplantation; Free light chains; Multiple myeloma; Prognostication; Tumor markers