Abstract
Multiple myeloma involvement of the central nervous system is rare, portends a poor prognosis, and requires rapid clinical intervention. The gold standard for diagnosis is cytology, which is highly insensitive. Abnormal free light chain detection in cerebrospinal fluid was more reliably concordant with clinical diagnosis of central nervous system multiple myeloma than cytology. Free light chain levels in cerebrospinal fluid dynamically correlated with response to therapy. Assessment of free light chains in cerebrospinal fluid can be included in the diagnostic algorithm to diagnose central nervous system multiple myeloma and monitor response to therapy.
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