Journal article
Monoclonal and polyclonal serum free light chains and clinical outcome in chronic lymphocytic leukemia
Blood, Vol.118(10), pp.2821-2826
09/08/2011
DOI: 10.1182/blood-2011-04-349134
PMCID: PMC3172798
PMID: 21765023
Abstract
Free light chains (FLCs) are the most commonly detected paraproteins in chronic lymphocytic leukemia (CLL). We examined the types of FLC abnormalities and prognostic utility of the FLC assay compared with standard prognostic biomarkers in a prospective cohort of 339 patients with newly diagnosed CLL. Three types of FLC abnormalities were identified: monoclonal elevated FLC (elevated κ and/or λ with abnormal FLC ratio), polyclonal elevated FLC (elevated κ and/or λ with normal FLC ratio), and ratio-only FLC abnormality (normal range κ and λ with abnormal FLC ratio). One hundred sixty-five patients (49%) had a FLC abnormality with approximately equal distribution among monoclonal elevation, polyclonal elevation, and ratio-only abnormality. All FLC abnormalities were associated with poor time to first treatment: monoclonal FLC (hazard ratio [HR], 4.99; 95% confidence interval [CI], 2.94-8.48), polyclonal FLC (HR, 2.40; 95% CI, 1.24-4.64), ratio-only FLC (HR, 2.57; 95% CI, 1.40-4.69). Monoclonal FLC and polyclonal FLC were associated with poor overall survival compared with patients with normal FLC. Results remained significant after adjusting for Rai stage. The FLC assay is a simple, widely available clinical test with similar prognostic utility as routinely used prognostic biomarkers for CLL. Among persons with FLC abnormalities, the type of abnormality affects prognostic significance.
Details
- Title: Subtitle
- Monoclonal and polyclonal serum free light chains and clinical outcome in chronic lymphocytic leukemia
- Creators
- Matthew J Maurer - Division of Biomedical Statistics and Informatics, Department of Health Sciences ResearchJames R Cerhan - Division of Epidemiology, Department of Health Sciences ResearchJerry A Katzmann - Division of Hematology, andBrian K Link - Division of Hematology, Oncology, and Blood and Marrow Transplantation, University of Iowa, Iowa City, IACristine Allmer - Division of Biomedical Statistics and Informatics, Department of Health Sciences ResearchClive S Zent - Division of Hematology, andTimothy G Call - Division of Hematology, andKari G Rabe - Division of Biomedical Statistics and Informatics, Department of Health Sciences ResearchCurtis A Hanson - Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN; andNeil E Kay - Division of Hematology, andSusan L Slager - Division of Biomedical Statistics and Informatics, Department of Health Sciences ResearchThomas E Witzig - Division of Hematology, andTait D Shanafelt - Division of Hematology, and
- Resource Type
- Journal article
- Publication Details
- Blood, Vol.118(10), pp.2821-2826
- DOI
- 10.1182/blood-2011-04-349134
- PMID
- 21765023
- PMCID
- PMC3172798
- NLM abbreviation
- Blood
- ISSN
- 0006-4971
- eISSN
- 1528-0020
- Publisher
- American Society of Hematology
- Grant note
- CA97274; CA113408 / National Institutes of Health
- Language
- English
- Date published
- 09/08/2011
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Epidemiology; Internal Medicine
- Record Identifier
- 9984094517902771
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