Serum Free Light Chain Profiles and Their Association with CRAB Features in Newly Diagnosed Multiple Myeloma Patients

Edakkadath Raghavan Sindhu; Athulya Gopinath; Emilin Zachariyas; Therayangalath Bindu; Vineetha Raghavan

doi:10.31557/RRO.2026.12.1.29

Authors

Edakkadath Raghavan Sindhu Department of Clinical Laboratory Services and Translational Research, Malabar Cancer Centre, Kannur, Kerala, India.
Athulya Gopinath Department of Clinical Laboratory Services and Translational Research, Malabar Cancer Centre, Kannur, Kerala, India.
Emilin Zachariyas Department of Clinical Laboratory Services and Translational Research, Malabar Cancer Centre, Kannur , Kerala- 670103, India
Therayangalath Bindu Department of Clinical Laboratory Services and Translational Research, Malabar Cancer Centre, Kannur , Kerala- 670103, India
Vineetha Raghavan Department of Clinical Laboratory Services and Translational Research, Malabar Cancer Centre, Kannur , Kerala- 670103, India

DOI:

https://doi.org/10.31557/RRO.2026.12.1.29

Keywords:

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Abstract

Introduction: Multiple myeloma (MM) is a hematological malignancy characterized by the clonal proliferation of plasma cells in the bone marrow, resulting in end-organ damage manifested as hypercalcemia, renal impairment, anemia, and bone lesions (CRAB criteria). This study aimed to evaluate the pattern of serum free light chain (FLC) elevation, determine the distribution of kappa and lambda light chains, and investigate the association between the kappa/lambda (κ/λ) ratio and CRAB features in newly diagnosed MM patients.

Materials and Methods: A retrospective observational study was conducted on 115 newly diagnosed multiple myeloma patients. Clinical and laboratory data, including serum free light chain levels, κ/λ ratio, serum calcium, creatinine clearance, hemoglobin concentration, and radiological evidence of bone lesions, were retrieved from medical records. Correlations between the κ/λ ratio and CRAB parameters were assessed using Pearson’s correlation coefficient, while categorical variables were analyzed using the Chi square test. A P value <0.05 was considered statistically significant.

Results: A significant weak negative correlation was observed between the κ/λ ratio and hemoglobin level (r = –0.199, P = 0.033), indicating that higher κ/λ ratios were associated with lower hemoglobin concentrations. No statistically significant correlations were found between the κ/λ ratio and creatinine clearance (r = –0.081, P = 0.391), serum calcium levels, or the presence of bone lesions. Among the study population, females constituted 53.0% of patients, while males accounted for 47.0%.

Conclusion: The serum κ/λ ratio showed a significant association with anemia but not with the other CRAB parameters in newly diagnosed multiple myeloma patients. These findings suggest that the κ/λ ratio may have clinical value as an indicator of disease burden, although larger prospective studies are required to validate its prognostic significance.