The Significance Of Serum Free Light Chain Detection In Evaluating The Prognosis Of Newly Diagnosed Multiple Myeloma Patients

Objective We explored the function of serum free light chain?s FLC?in the prognosis of newly diagnosed multiple myeloma?MM?patients.Methods Retrospective analysis was conducted on 40 newly diagnosed MM patients who were admitted to Subei People's Hospital of Jiangsu from January 1,2015to December 31,2019.The clinical data was comprised of age,sex,complete blood count,serum albumin,globulin,calcium,creatinine,lactate dehydrogenase?LDH?,beta-2 microglobulin,the results of serum protein electrophoresis?SPEP?and immunofixation electrophoresis?IFE?,quantitation of monoclonal proteins,clonal bone marrow plasma cells percentage,the results of bone marrow biopsy,positron emission tomography-computed tomography?PET-CT?,whole body bone magnetic resonance imaging?MRI?,and regime of treatment.Freelite^TM analysis was conducted to detect?and?s FLC.International staging system?ISS?and Durie-Salmon?DS?staging system were applied to determine the disease stage.High and low groups were divided by the calculated?and?s FLC median.We also calculated involved÷uninvolved FLC ratio?r FLC?.Receiver operating characteristic curve?ROC curve?was used to determine the best cut-off of s FLC ratio.Thus,high r FLC group and low r FLC group were divided by the best cut-off of s FLC ratio.Kaplan-Meier method was used for survival analysis.P<0.05 indicated significant difference.Results1.Shorter than the not reached?NR?low s FLC absolute value group,the median survival time of the high s FLC absolute value group was 80.6 weeks.2.Compared to patients in low r FLC group?n=27?,high r FLC group?n=13?patients had significantly higher serum calcium,beta-2 microglobulin,creatinine and clonal plasma cells percentage.Also,high r FLC group had more ISS?stage patients.Moreover,significant different overall survival?OS?was found between two groups.However,the differences in sex,age,hemoglobin,white blood cell count,platelet,globulin,M protein,platelet,LDH and DS stage between two groups were not significant.3.In contrast to?s FLC group?n=21?,?s FLC group?n=19?had a higher percentage of plasma cells.Patients'kidney disease held major accountability for the hospital visit in the?s FLC group,and patients were more likely to have renal insufficiency.No significant OS difference was identified between two groups,though.4.Created a risk stratification model with improved prognostic capabilities,we incorporated involved÷uninvolved r FLC greater than or equal to 98 with the ISS risk factors,albumin less than 35 g/L and serum beta2-microglobulin greater than or equal to5.5?g/m L.Low risk group had no or one risk factor,while high risk group had two or three risk factors.We noticed a marked OS difference between low risk group?n=29?and high risk group?n=11?,with median survival times of 64.0 and 27.3 weeks,respectively.Conclusions1.Disease status would become more invasive if newly diagnosed MM patients had significantly abnormal s FLC absolute values and ratio.Such MM patients tended to have higher tumor load and shorter OS,which may indicate poorer prognosis.2.We discovered that patients with?s FLC involved were more likely to have renal insufficiency,but there were no significant OS differences between the?s FLC involved patients and?s FLC involved patients.3.We incorporated involved÷uninvolved r FLC greater than or equal to 98 with the ISS risk factors to create a new risk stratification model with improved prognostic capabilities.