Journal article
Elevated Monoclonal and Polyclonal Serum Immunoglobulin Free Light Chain (FLC) as Prognostic Factors in B- and T-cell Non-Hodgkin Lymphoma
American journal of hematology, Vol.89(12), pp.1116-1120
12/2014
DOI: 10.1002/ajh.23839
PMCID: PMC4362722
PMID: 25228125
Abstract
The serum immunoglobulin free light chain (FLC) assay quantitates free kappa (κ) and lambda (λ) light chains. FLC elevations in patients with diffuse large B-cell lymphoma (DLBCL), Hodgkin lymphoma (HL), and chronic lymphocytic leukemia (CLL) are associated with an inferior survival. These increases in FLC can be monoclonal (as in myeloma) or polyclonal. The goal was to estimate the frequency of these elevations within distinct types of B-cell and T-cell non-Hodgkin lymphoma (NHL) and whether the FLC measurements are associated with event-free survival (EFS). We studied serum for FLC abnormalities using normal laboratory reference ranges to define an elevated κ or λ FLC. Elevations were further classified as polyclonal or monoclonal. 492 patients were studied: 453 B-cell and 34 T-cell NHL patients. 29% (142/453) had an elevated FLC of which 10% were monoclonal elevations. Within B-cell NHL, FLC abnormalities were most common in lymphoplasmacytic lymphoma (79%), MCL (68%) and MALT (31%); they were least common in FL (15%). The hazard ratio (HR) for EFS in all patients was 1.41 (95% CI; 1.11–1.81); in all B-cell NHL the HR was 1.44 (95% CI 1.11–1.96); in all T-cell NHL the HR was 1.17 (95% CI 0.55–2.49). FLC abnormalities predicted an inferior OS (HR = 2.75, 95% CI: 1.93–3.90, p<0.0001). The serum FLC assay is useful for prognosis in both B-cell and T-cell types of NHL. In B-cell NHL further discrimination between a monoclonal and polyclonal elevation may be helpful and should be analyzed in prospective clinical trials.
Details
- Title: Subtitle
- Elevated Monoclonal and Polyclonal Serum Immunoglobulin Free Light Chain (FLC) as Prognostic Factors in B- and T-cell Non-Hodgkin Lymphoma
- Creators
- Thomas E Witzig - Division of Hematology, Mayo Clinic, Rochester MNMatthew J Maurer - Department of Health Sciences, Mayo Clinic, Rochester, MNThomas M Habermann - Division of Hematology, Mayo Clinic, Rochester MNBrian K Link - Department of Health Sciences, Mayo Clinic, Rochester, MNIvana N. M Micallef - Division of Hematology, Mayo Clinic, Rochester MNGrzegorz S Nowakowski - Division of Hematology, Mayo Clinic, Rochester MNStephen M Ansell - Division of Hematology, Mayo Clinic, Rochester MNJoseph P Colgan - Division of Hematology, Mayo Clinic, Rochester MNDavid J Inwards - Division of Hematology, Mayo Clinic, Rochester MNLuis F Porrata - Division of Hematology, Mayo Clinic, Rochester MNSvetomir N Markovic - Division of Hematology, Mayo Clinic, Rochester MNPatrick B Johnston - Division of Hematology, Mayo Clinic, Rochester MNYi Lin - Division of Hematology, Mayo Clinic, Rochester MNCarrie Thompson - Division of Hematology, Mayo Clinic, Rochester MNMamta Gupta - Division of Hematology, Mayo Clinic, Rochester MNJerry A Katzmann - Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MNJames R Cerhan - Department of Health Sciences, Mayo Clinic, Rochester, MN
- Resource Type
- Journal article
- Publication Details
- American journal of hematology, Vol.89(12), pp.1116-1120
- DOI
- 10.1002/ajh.23839
- PMID
- 25228125
- PMCID
- PMC4362722
- ISSN
- 0361-8609
- eISSN
- 1096-8652
- Grant note
- name: Predolin Foundation, award: P50 CA97274, R01 CA129539, R01 CA127433
- Language
- English
- Date published
- 12/2014
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Epidemiology; Internal Medicine
- Record Identifier
- 9984094387702771
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