Journal article
Elevated Serum Free Light Chains Are Associated With Event-Free and Overall Survival in Two Independent Cohorts of Patients With Diffuse Large B-Cell Lymphoma
Journal of clinical oncology, Vol.29(12), pp.1620-1626
04/20/2011
DOI: 10.1200/JCO.2010.29.4413
PMCID: PMC3082979
PMID: 21383282
Abstract
PurposeThe serum free light chain (FLC) assay quantitates free kappa (κ) and free lambda (λ) immunoglobulin light chains. This assay has prognostic value in plasma cell proliferative disorders. There are limited data on serum FLC in B-cell malignancies.Patients and MethodsThe association of pretreatment FLC with event-free survival (EFS) and overall survival (OS) in diffuse large B-cell lymphoma (DLBCL) was evaluated in 76 patients from the North Central Cancer Treatment Group trial N0489 (NCT00301821) and 219 patients from the University of Iowa/Mayo Clinic Specialized Program of Research Excellence Molecular Epidemiology Resource (MER). Published reference ranges were used to define an elevated FLC or an abnormal κ:λ FLC ratio.ResultsElevated FLC or abnormal κ:λ FLC ratio was present in 32% and 14% of patients, respectively. Patients with elevated FLC had an inferior OS and EFS in both cohorts compared with patients with normal FLC (N0489: EFS hazard ratio [HR], 3.06; OS HR, 3.16; both P < .02; MER: EFS HR, 2.42; OS HR, 3.40; both P < .001; combined EFS HR, 2.57; OS HR, 3.74; both P < .001). All associations remained significant for EFS and OS after adjusting for the International Prognostic Index (IPI). Abnormal κ:λ FLC ratio was modestly associated with outcome in the combined group (EFS HR, 1.61; OS HR, 1.67; both P = .07), but not in patients without corresponding elevated κ or λ. Elevated FLC was the strongest predictor of outcome in multivariable models with the IPI components.ConclusionIncreased serum FLC is an independent, adverse prognostic factor for EFS and OS in DLBCL and warrants further evaluation as a biomarker in DLBCL.
Details
- Title: Subtitle
- Elevated Serum Free Light Chains Are Associated With Event-Free and Overall Survival in Two Independent Cohorts of Patients With Diffuse Large B-Cell Lymphoma
- Creators
- Matthew J Maurer - From the Mayo Clinic College of Medicine and Mayo Foundation, Rochester; Duluth Community Clinical Oncology Program, Duluth, MN; and University of Iowa, Iowa City, IAIvana N.M Micallef - From the Mayo Clinic College of Medicine and Mayo Foundation, Rochester; Duluth Community Clinical Oncology Program, Duluth, MN; and University of Iowa, Iowa City, IAJames R Cerhan - From the Mayo Clinic College of Medicine and Mayo Foundation, Rochester; Duluth Community Clinical Oncology Program, Duluth, MN; and University of Iowa, Iowa City, IAJerry A Katzmann - From the Mayo Clinic College of Medicine and Mayo Foundation, Rochester; Duluth Community Clinical Oncology Program, Duluth, MN; and University of Iowa, Iowa City, IABrian K Link - From the Mayo Clinic College of Medicine and Mayo Foundation, Rochester; Duluth Community Clinical Oncology Program, Duluth, MN; and University of Iowa, Iowa City, IAJoseph P Colgan - From the Mayo Clinic College of Medicine and Mayo Foundation, Rochester; Duluth Community Clinical Oncology Program, Duluth, MN; and University of Iowa, Iowa City, IAThomas M Habermann - From the Mayo Clinic College of Medicine and Mayo Foundation, Rochester; Duluth Community Clinical Oncology Program, Duluth, MN; and University of Iowa, Iowa City, IADavid J Inwards - From the Mayo Clinic College of Medicine and Mayo Foundation, Rochester; Duluth Community Clinical Oncology Program, Duluth, MN; and University of Iowa, Iowa City, IASvetomir N Markovic - From the Mayo Clinic College of Medicine and Mayo Foundation, Rochester; Duluth Community Clinical Oncology Program, Duluth, MN; and University of Iowa, Iowa City, IAStephen M Ansell - From the Mayo Clinic College of Medicine and Mayo Foundation, Rochester; Duluth Community Clinical Oncology Program, Duluth, MN; and University of Iowa, Iowa City, IALuis F Porrata - From the Mayo Clinic College of Medicine and Mayo Foundation, Rochester; Duluth Community Clinical Oncology Program, Duluth, MN; and University of Iowa, Iowa City, IAPatrick B Johnston - From the Mayo Clinic College of Medicine and Mayo Foundation, Rochester; Duluth Community Clinical Oncology Program, Duluth, MN; and University of Iowa, Iowa City, IAGrzegorz S Nowakowski - From the Mayo Clinic College of Medicine and Mayo Foundation, Rochester; Duluth Community Clinical Oncology Program, Duluth, MN; and University of Iowa, Iowa City, IACarrie A Thompson - From the Mayo Clinic College of Medicine and Mayo Foundation, Rochester; Duluth Community Clinical Oncology Program, Duluth, MN; and University of Iowa, Iowa City, IAMamta Gupta - From the Mayo Clinic College of Medicine and Mayo Foundation, Rochester; Duluth Community Clinical Oncology Program, Duluth, MN; and University of Iowa, Iowa City, IASergei I Syrbu - From the Mayo Clinic College of Medicine and Mayo Foundation, Rochester; Duluth Community Clinical Oncology Program, Duluth, MN; and University of Iowa, Iowa City, IAPaul J Kurtin - From the Mayo Clinic College of Medicine and Mayo Foundation, Rochester; Duluth Community Clinical Oncology Program, Duluth, MN; and University of Iowa, Iowa City, IAWilliam R Macon - From the Mayo Clinic College of Medicine and Mayo Foundation, Rochester; Duluth Community Clinical Oncology Program, Duluth, MN; and University of Iowa, Iowa City, IADaniel A Nikcevich - From the Mayo Clinic College of Medicine and Mayo Foundation, Rochester; Duluth Community Clinical Oncology Program, Duluth, MN; and University of Iowa, Iowa City, IAThomas E Witzig - From the Mayo Clinic College of Medicine and Mayo Foundation, Rochester; Duluth Community Clinical Oncology Program, Duluth, MN; and University of Iowa, Iowa City, IA
- Resource Type
- Journal article
- Publication Details
- Journal of clinical oncology, Vol.29(12), pp.1620-1626
- DOI
- 10.1200/JCO.2010.29.4413
- PMID
- 21383282
- PMCID
- PMC3082979
- ISSN
- 0732-183X
- eISSN
- 1527-7755
- Language
- English
- Date published
- 04/20/2011
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Epidemiology; Pathology; Internal Medicine
- Record Identifier
- 9984047678302771
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