| Objective:clinical significance of serum free light chain (sFLC) test in the diagnosis, efficacy evaluation, prognosis judgment of first onset of multiple myeloma (MM).Method:Medical records of45cases of first-onset MM were gathered in our hospital from1/2010to6/2012. sFLC-κ and sFLC-λ were determined by immune turbidimetric assay, sFLC-κ/λ(rFLC) were calculated and the results were compared with that of immunofixation electrophoresis (IFE) as well as serum protein electrophoresis (SPE) for sensitivity assessment. All patients were treated with chemotherapy followed by sFLC detection and efficacy assessment. Patients with a sFLC results higher than median were marked as high-FLC, the rest were marked as low-FLC, and survival analysis were made comparing the two groups.Results:Of45first-onset patients with multiple myeloma (MM),44were sFLC and rFLC positive, that’s a sensitivity of97.8%.All3non-secretory MM patients gave positive results. sFLC value showed no correlation with sex or age, but in certain degree it was correlated with D-S staging while its correlation with ISS staging was not so obvious. Patients with light chain MM had higher level of sFLC. By comparing serum IFE and SPE levels before and after treatment, sFLC showed a higher sensitivity. sFLC level was closely associated with efficacy of treatment and provided an early sign for disease progression. Survival analysis from follow-up data showed that OS and TTP were longer in group with lower sFLC level than that in group with higher sFLC level and patients with rFLC in the range of0.03-32, had advantageous OS and TTP over patients with higher level of rFLC as it required much longer TTP and OS to transit to sCR patients.Conclusion:sFLC detection is a highly sensitive quantitative method, can help the diagnosis of MM, gives a quicker assessment of treatment efficacy, and can predict disease recurrence. When it’s the first onset, sFLC level can also roughly forecast the prognosis. |
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