Responses in multiple myeloma should be assigned according to serum, not urine, free light chain measurements

Leukemia. 2019 Feb;33(2):313-318. doi: 10.1038/s41375-018-0339-y. Epub 2018 Dec 20.

Abstract

The most recent update to the International Myeloma Working Group consensus criteria places a strong emphasis on the need for more sensitive haematological markers of response driven by the success of novel therapies. One such marker is serum free light chain (sFLC) analysis, which was first incorporated into the definition of stringent complete response in 2006. However, over the past decade there has been some reluctance to extend the role of the sFLC assays to replace 24 h urine electrophoresis for monitoring multiple myeloma (MM). In this review, we lay out the evidence in favour of serum over urine for monoclonal FLC measurements and propose modified criteria for response assignment in myeloma.

Publication types

  • Review

MeSH terms

  • Biomarkers, Tumor / analysis*
  • Humans
  • Immunoglobulin Light Chains / blood*
  • Immunoglobulin Light Chains / urine*
  • Multiple Myeloma / blood
  • Multiple Myeloma / diagnosis*
  • Practice Guidelines as Topic / standards*

Substances

  • Biomarkers, Tumor
  • Immunoglobulin Light Chains