The t(11;14) translocation, deleting the heavy chain locus, likely accounts for the high frequency of FLC-producing clones in AL.(20) It is possible then that FLC criteria, IGLV gene identification and the ascertainment of t(11;14) and gain 1q in clonal plasma cells may be useful variables in an algorithm for screening SMM patients for risk of AL. Here, IGLL5 is linked to axial length measurement.