The significance of free light-chain ratio in light-chain monoclonal gammopathy of undetermined significance : a flow cytometry sub-study of the iStopMM screening study
(2024) In Blood Cancer Journal 14(1).- Abstract
Light-chain (LC) monoclonal gammopathy of undetermined significance (MGUS) is a precursor of multiple myeloma (MM) and related conditions. LC-MGUS is characterized by free light-chain (FLC) levels outside defined reference intervals, indirectly indicating underlying plasma cell (PC) monoclonality. Next-generation flow cytometry (NGF) was used to evaluate clonal PC presence in bone marrow (BM) samples from individuals with LC-MGUS in the iStopMM study, aiming to assess the predictive value of the FLC ratio for clonal PC presence and its prognostic implications. BM samples from 61 individuals with LC monoclonal gammopathy were analyzed. Clonal plasma cells were detected in 53.6% of LC-MGUS samples (n = 28) and in all samples from... (More)
Light-chain (LC) monoclonal gammopathy of undetermined significance (MGUS) is a precursor of multiple myeloma (MM) and related conditions. LC-MGUS is characterized by free light-chain (FLC) levels outside defined reference intervals, indirectly indicating underlying plasma cell (PC) monoclonality. Next-generation flow cytometry (NGF) was used to evaluate clonal PC presence in bone marrow (BM) samples from individuals with LC-MGUS in the iStopMM study, aiming to assess the predictive value of the FLC ratio for clonal PC presence and its prognostic implications. BM samples from 61 individuals with LC monoclonal gammopathy were analyzed. Clonal plasma cells were detected in 53.6% of LC-MGUS samples (n = 28) and in all samples from individuals with more advanced conditions (n = 33). The FLC ratio was predictive of clonal PC presence for kappa-involved FLC ratios (p < 0.05; n = 42), with an optimal cutoff of 3.15 (96.7% sensitivity, 91.7% specificity). Of 195 individuals with kappa-involved LC-MGUS in follow-up within the iStopMM study, none with FLC ratios >1.65 to 3.15 progressed to MM (n = 124), whereas 4/71 (5.6%) with FLC ratios >3.15 progressed over median follow-up of 55 months. These findings support using a kappa-involved FLC ratio cutoff of >3.15 to more accurately identify individuals at increased risk of developing symptomatic PC disorders.
(Less)
- author
- publishing date
- 2024-12-18
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Humans, Flow Cytometry/methods, Male, Monoclonal Gammopathy of Undetermined Significance/diagnosis, Female, Aged, Middle Aged, Immunoglobulin Light Chains/blood, Aged, 80 and over, Adult, Prognosis, Plasma Cells/pathology
- in
- Blood Cancer Journal
- volume
- 14
- issue
- 1
- article number
- 221
- publisher
- Nature Publishing Group
- external identifiers
-
- scopus:85212513206
- pmid:39695077
- ISSN
- 2044-5385
- DOI
- 10.1038/s41408-024-01201-9
- language
- English
- LU publication?
- no
- additional info
- © 2024. The Author(s).
- id
- 074f7d9b-da4a-4574-967c-6346bbba8342
- date added to LUP
- 2024-12-22 13:55:54
- date last changed
- 2025-07-11 20:04:53
@article{074f7d9b-da4a-4574-967c-6346bbba8342,
abstract = {{<p>Light-chain (LC) monoclonal gammopathy of undetermined significance (MGUS) is a precursor of multiple myeloma (MM) and related conditions. LC-MGUS is characterized by free light-chain (FLC) levels outside defined reference intervals, indirectly indicating underlying plasma cell (PC) monoclonality. Next-generation flow cytometry (NGF) was used to evaluate clonal PC presence in bone marrow (BM) samples from individuals with LC-MGUS in the iStopMM study, aiming to assess the predictive value of the FLC ratio for clonal PC presence and its prognostic implications. BM samples from 61 individuals with LC monoclonal gammopathy were analyzed. Clonal plasma cells were detected in 53.6% of LC-MGUS samples (n = 28) and in all samples from individuals with more advanced conditions (n = 33). The FLC ratio was predictive of clonal PC presence for kappa-involved FLC ratios (p < 0.05; n = 42), with an optimal cutoff of 3.15 (96.7% sensitivity, 91.7% specificity). Of 195 individuals with kappa-involved LC-MGUS in follow-up within the iStopMM study, none with FLC ratios >1.65 to 3.15 progressed to MM (n = 124), whereas 4/71 (5.6%) with FLC ratios >3.15 progressed over median follow-up of 55 months. These findings support using a kappa-involved FLC ratio cutoff of >3.15 to more accurately identify individuals at increased risk of developing symptomatic PC disorders.</p>}},
author = {{Óskarsson, Jón Þórir and Rögnvaldsson, Sæmundur and Thorsteinsdottir, Sigrun and Long, Thorir Einarsson and Ólafsson, Andri and Eythorsson, Elias and Jónsson, Ásbjörn and Viðarsson, Brynjar and Önundarson, Páll T and Agnarsson, Bjarni A and Pálmason, Róbert and Sigurðardóttir, Margrét and Þorsteinsdóttir, Ingunn and Ólafsson, Ísleifur and Harding, Stephen J and Durie, Brian G M and Love, Thorvardur Jon and Kristinsson, Sigurdur Y}},
issn = {{2044-5385}},
keywords = {{Humans; Flow Cytometry/methods; Male; Monoclonal Gammopathy of Undetermined Significance/diagnosis; Female; Aged; Middle Aged; Immunoglobulin Light Chains/blood; Aged, 80 and over; Adult; Prognosis; Plasma Cells/pathology}},
language = {{eng}},
month = {{12}},
number = {{1}},
publisher = {{Nature Publishing Group}},
series = {{Blood Cancer Journal}},
title = {{The significance of free light-chain ratio in light-chain monoclonal gammopathy of undetermined significance : a flow cytometry sub-study of the iStopMM screening study}},
url = {{http://dx.doi.org/10.1038/s41408-024-01201-9}},
doi = {{10.1038/s41408-024-01201-9}},
volume = {{14}},
year = {{2024}},
}