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Chapter 18

Many studies have indicated that the reduction in sFLCs after one or two cycles of treatment is highly predictive of overall response. For example, Dispenzieri et al. [402] reported that a 90% reduction in sFLCs (90% reduction in the difference between the involved and uninvolved FLC [dFLC]) within 7 days post-ASCT predicted for haematologic complete response (p<0.001). Other studies have similarly highlighted the value of early sFLC reductions in predicting overall response [394][395][396][347][403]. Looking at a different measure of outcome, Orlowski et al. [361] reported that rapid normalisation of the FLC κ/λ ratio - after the first or second cycle of therapy - was highly predictive of prolonged time to progression. The prognostic value of the sFLC response is discussed further in Chapter 20.

References

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    • 2. Orlowski R, Sutherland H, Blade J, Miguel JS, Hajek R, Nagler A et al. Early normalization of serum free light chains is associated with prolonged time to progression following bortezomib {+/-} pegylated liposomal doxorubicin treatment of relapsed/ refractory multiple myeloma. Blood 2007;110:2735a
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