Prognostic value of serum free light chain ratio at diagnosis in multiple myeloma


Gerassimos A. Pangalis, First Department of Internal Medicine and Department of Haematology, National and Kapodistrian University of Athens, Laikon General Hospital, Agiou Thoma 17, Athens 11527, Greece. E-mail: and


The prognostic value of baseline serum free light chain ratio (sFLCR) was investigated in 94 multiple myeloma (MM) patients. sFLCR was calculated as κ/λ or λ/κ, depending on the patients’ dominating monoclonal light chain. Median baseline sFLCR was 3·57 in κ-MM patients, 45·09 in λ-MM. ‘High’ sFLCR (≥ the observed median value for κ- and λ-MM respectively) correlated with elevated serum creatinine and lactate dehydrogenase, extensive marrow infiltration and light chain type MM. The 5-year disease-specific survival was 82% and 30% in patients with sFLCR lower than and equal or greater than the median, respectively (P = 0·0001). sFLCR was an independent prognostic factor.