{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T19:17:39Z","timestamp":1778527059264,"version":"3.51.4"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Monoclonal immunoglobulins provide an indication of the tumor burden in patients with plasma cell neoplasms. Higher concentrations of serum free light chains in light chain predominant multiple myeloma have been shown to correlate with a poorer outcome. We examined the correlations of serum free light chain concentrations in light chain myelomas with survival, estimated glomerular filtration rate (eGFR) and other clinical and pathological parameters.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Records of patients with light chain multiple myelomas were reviewed. Highest concentration of serum free light chains for each patient were plotted to ascertain an inflection\/change point. Survival, eGFR, and other clinical and pathological parameters were compared between the low and high light chain concentration groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Plotting serum free light chain concentrations revealed an inflection point at a concentration of 455\u2009mg\/L apportioning patients in to 2 subgroups: 39 patients with low light chain concentrations and 26 patients with high concentrations. The high concentration group had more unfavorable pathology in bone marrow examination in terms of higher neoplastic plasma cell burden and high-risk cytogenetics. The survival rate and eGFR in the high concentration group were significantly worse than in the low concentration group.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>As noted for light chain predominant multiple myeloma, high serum free light chain concentration in light chain multiple myelomas are associated with higher renal disease burden and shorter survival. Monitoring of serum free light chain concentrations and customizing treatments to address this parameter are warranted.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jalm\/jfab090","type":"journal-article","created":{"date-parts":[[2021,7,29]],"date-time":"2021-07-29T19:17:26Z","timestamp":1627586246000},"page":"1592-1600","source":"Crossref","is-referenced-by-count":11,"title":["Light Chain Multiple Myeloma: High Serum Free Light Chain Concentrations Portend Renal Damage and Poorer Survival"],"prefix":"10.1093","volume":"6","author":[{"given":"Yulan","family":"Jin","sequence":"first","affiliation":[{"name":"Department of Pathology, Augusta University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasha M","family":"Savage","sequence":"additional","affiliation":[{"name":"Department of Pathology, Medical College of Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roni J","family":"Bollag","sequence":"additional","affiliation":[{"name":"Department of Pathology, Medical College of Georgia at Augusta University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongyan","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Sciences, Augusta University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0621-7254","authenticated-orcid":false,"given":"Gurmukh","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology, Truman Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,9,1]]},"reference":[{"key":"2021110213161144600_jfab090-B1","doi-asserted-by":"crossref","first-page":"4701","DOI":"10.1182\/blood-2010-10-299529","article-title":"Consensus recommendation for standard investigative workup: report of International Myeloma Workshop 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Med"},{"key":"2021110213161144600_jfab090-B5","doi-asserted-by":"crossref","first-page":"2582","DOI":"10.1056\/NEJMoa070389","article-title":"Clinical course and prognosis of smoldering (asymptomatic) multiple myeloma","volume":"356","author":"Kyle","year":"2007","journal-title":"N Engl J Med"},{"key":"2021110213161144600_jfab090-B6","doi-asserted-by":"crossref","first-page":"1358","DOI":"10.1093\/jalm\/jfaa153","article-title":"Serum and urine protein electrophoresis and serum free light chain assays in the diagnosis and monitoring of monoclonal gammopathies","volume":"5","author":"Singh","year":"2020","journal-title":"J Appl Lab Med"},{"key":"2021110213161144600_jfab090-B7","doi-asserted-by":"crossref","first-page":"46","DOI":"10.14740\/jocmr2802w","article-title":"Serum free light chain assay and \u03ba\/\u03bb Ratio: performance in patients with monoclonal gammopathy-high false negative rate for \u03ba\/\u03bb ratio","volume":"9","author":"Singh","year":"2017","journal-title":"J Clin Med Res"},{"key":"2021110213161144600_jfab090-B8","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1001\/jamaoncol.2017.4600","article-title":"Autologous transplantation for newly diagnosed multiple myeloma in the era of novel agent induction: a systematic review and meta-analysis","volume":"4","author":"Dhakal","year":"2018","journal-title":"JAMA Oncol"},{"key":"2021110213161144600_jfab090-B9","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1056\/NEJMoa1611750","article-title":"Lenalidomide, bortezomib, and dexamethasone with transplantation for myeloma","volume":"376","author":"Attal","year":"2017","journal-title":"N Engl J Med"},{"issue":"4","key":"2021110213161144600_jfab090-B10","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1093\/labmed\/lmaa057","article-title":"Light chain predominant intact immunoglobulin monoclonal gammopathy disorder: shorter survival in light chain predominant multiple myelomas","volume":"52","author":"Singh","year":"2021","journal-title":"Lab Med"},{"key":"2021110213161144600_jfab090-B11","article-title":"Light chain-predominant multiple myeloma subgroup; Impaired renal function correlates with decreased survival in this subgroup","author":"Singh","journal-title":"Lab Med."},{"key":"2021110213161144600_jfab090-B12","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1093\/ajcp\/aqw099","article-title":"Serum free light chain assay and \u03ba\/\u03bb Ratio: performance in patients without monoclonal gammopathies \u2013 high false positive rate","volume":"146","author":"Singh","year":"2016","journal-title":"Am J Clin Pathol"},{"key":"2021110213161144600_jfab090-B13","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1093\/labmed\/lmy067","article-title":"Concentrations of serum free light chains in kappa and lambda lesions in light-chain myelomas","volume":"50","author":"Singh","year":"2019","journal-title":"Lab 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