{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T11:39:27Z","timestamp":1775129967583,"version":"3.50.1"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,8,13]],"date-time":"2021-08-13T00:00:00Z","timestamp":1628812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Patients with light chain\u2013predominant multiple myeloma have been shown to exhibit shorter survival. Retrospective comparison of clinical and laboratory data was undertaken to ascertain the likely cause(s) of this observation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Records of patients with multiple myeloma seen at 1 institution revealed 316 patients with conventional and 71 patients with light chain\u2013predominant multiple myelomas with secretion of intact immunoglobulins. Laboratory and clinical findings in the 2 groups were compared.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Patients with light chain\u2013predominant multiple myeloma had a significantly higher death rate, a higher rate of chronic dialysis, a lower estimated glomerular filtration rate and serum albumin, a significantly higher urine protein concentration, and a significantly higher prevalence of hypertension and blood transfusion requirements. Other clinical and laboratory parameters surveyed were not significantly different between the 2 groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The shorter survival of patients with light chain\u2013predominant multiple myeloma is clearly associated with renal damage caused by excess free immunoglobulin light chains. Renal damage may be ameliorated by early aggressive treatment with chemotherapy, plasmapheresis, and dialysis; a multi-institutional prospective controlled trial would be needed to test this hypothesis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/labmed\/lmab054","type":"journal-article","created":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T19:16:57Z","timestamp":1621279017000},"page":"145-148","source":"Crossref","is-referenced-by-count":14,"title":["Light Chain\u2013Predominant Multiple Myeloma Subgroup: Impaired Renal Function Correlates with Decreased Survival"],"prefix":"10.1093","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0621-7254","authenticated-orcid":false,"given":"Gurmukh","family":"Singh","sequence":"first","affiliation":[{"name":"Division of Clinical Pathology, Department of Pathology, Medical College of Georgia at Augusta University , Augusta, Georgia , US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasha M","family":"Savage","sequence":"additional","affiliation":[{"name":"Division of Clinical Pathology, Department of Pathology, Medical College of Georgia at Augusta University , Augusta, Georgia , US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anand P","family":"Jillella","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine, Medical College of Georgia at Augusta University , Augusta, Georgia , US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roni J","family":"Bollag","sequence":"additional","affiliation":[{"name":"Division of Clinical Pathology, Department of Pathology, Medical College of Georgia at Augusta University , Augusta, Georgia , US"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,8,13]]},"reference":[{"issue":"13","key":"2023020416002322100_CIT0001","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.1056\/NEJMoa054494","article-title":"Prevalence of monoclonal gammopathy of undetermined significance","volume":"354","author":"Kyle","year":"2006","journal-title":"N Engl J Med."},{"issue":"3","key":"2023020416002322100_CIT0002","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1056\/NEJMoa1709974","article-title":"Long-term follow-up of monoclonal gammopathy of undetermined significance","volume":"378","author":"Kyle","year":"2018","journal-title":"N Engl J Med."},{"issue":"25","key":"2023020416002322100_CIT0003","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."},{"issue":"11","key":"2023020416002322100_CIT0004","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1056\/NEJMra1011442","article-title":"Multiple myeloma","volume":"364","author":"Palumbo","year":"2011","journal-title":"N Engl J Med."},{"issue":"6","key":"2023020416002322100_CIT0005","first-page":"373","article-title":"Multiple myeloma: diagnosis and treatment","volume":"95","author":"Michels","year":"2017","journal-title":"Am Fam Physician."},{"issue":"7","key":"2023020416002322100_CIT0006","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1182\/blood-2018-09-825331","article-title":"Toward personalized treatment in multiple myeloma based on molecular characteristics","volume":"133","author":"Pawlyn","year":"2019","journal-title":"Blood."},{"issue":"10068","key":"2023020416002322100_CIT0007","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1016\/S0140-6736(16)31594-X","article-title":"Bortezomib with lenalidomide and dexamethasone versus lenalidomide and dexamethasone alone in patients with newly diagnosed myeloma without intent for immediate autologous stem-cell transplant (SWOG S0777): a randomised, open-label, phase 3 trial","volume":"389","author":"Durie","year":"2017","journal-title":"Lancet."},{"key":"2023020416002322100_CIT0008","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1056\/NEJMoa1611750","article-title":"Lenalidomide, bortezomib, and dexamethasone with transplantation for myeloma","volume":"376","author":"Lauwers-Cances","year":"2017","journal-title":"N Engl J 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gammopathies\u2014high false positive rate","volume":"146","author":"Singh","year":"2016","journal-title":"Am J Clin Pathol."},{"key":"2023020416002322100_CIT0012","volume-title":"Serum Free Light Chain Analysis: Plus Hevylite.","author":"Bradwell","year":"2015","edition":"7"},{"issue":"6","key":"2023020416002322100_CIT0013","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":"2023020416002322100_CIT0014","article-title":"Light chain predominant intact immunoglobulin monoclonal gammopathy disorders: shorter survival in light chain-predominant multiple myelomas","author":"Singh","journal-title":"Lab 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