Soluble B-cell maturation antigen distribution in serum and lacrimal fluid of multiple myeloma patients and healthy volunteers. Violin plots were used to show the levels of soluble B-cell maturation antigen (sBCMA) (ng/mL) in serum versus lacrimal fluid. (A) Three-group comparison revealed a significant increase (one-way ANOVA, P=0.0091) of serum sBCMA levels for patients at the time of progressive disease (PD, N=4, mean 1,544 ng/mL; range, 162.6-3,607 ng/mL) if compared to healthy volunteers (HV, N=7, mean 12.9 ng/mL; range, 8.8-18.9 ng/mL) and patients with a remission state of stable disease (SD) or better (N=5, mean 39.0 ng/mL; range, 5.8-56.1 ng/mL). (B) For lacrimal fluid, this increase in sBCMA levels for PD patients (mean 621.3 ng/mL; range, 23.0-937 ng/mL) versus patients with ≥SD (mean 2.7 ng/mL; range, 0.2-7.7 ng/mL) versus HV (mean 1.5 ng/mL; range, 0.4-2.9 ng/mL) was even more pronounced (one-way ANOVA, P=0.0004). **P<0.005; ***P<0.0005.