20.2.2. Association between sFLCs and other prognostic markers

Chapter 20

Most of the studies discussed in this chapter have sought to establish whether FLC analysis is prognostic independently of other markers. However, it would also be of value if a simple serum test could replace a more expensive and/or invasive investigation such as multi-parameter flow cytometry or cytogenetic analysis.

Kumar et al. [446] studied the relationship between sFLC results and the presence of IgH translocations in 314 MM patients at diagnosis. The median κ/λ sFLC ratio and dFLC were higher in patients with IgH translocations, particularly t(14;16), but multivariate analysis indicated that sFLC abnormalities were independent risk factors and better prognosis was obtained using a combination of both the genetic and sFLC risk factors.