| Monoclonal and polyclonal serum free light chains and clinical outcome in chronic lymphocytic leukemia. | |
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MedLine Citation:
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PMID: 21765023 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Free light chains (FLC) 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 to standard prognostic biomarkers in a prospective cohort of 339 newly diagnosed CLL patients. 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 (49%) patients had a FLC abnormality with approximately equal distribution between monoclonal elevation, polyclonal elevation, and ratio-only abnormality. All FLC abnormalities were associated with poor time to first treatment: monoclonal FLC (HR=4.99,95% 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 to patients with normal FLC. Results remained significant after adjusting for Rai stage. The prognostic ability of FLC compared favorably to established CLL prognostic parameters (e.g. IGHV, ZAP70, FISH). The FLC assay is a simple, widely available clinical test with similar prognostic utility as routinely used prognostic biomarkers for CLL. Among individuals with FLC abnormalities, the type of abnormality impacts prognostic significance. |
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Authors:
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Matthew J Maurer; James R Cerhan; Jerry A Katzmann; Brian K Link; Cristine Allmer; Clive S Zent; Timothy G Call; Kari G Rabe; Curtis A Hanson; Neil E Kay; Susan L Slager; Thomas E Witzig; Tait D Shanafelt |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-7-15 |
Journal Detail:
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Title: Blood Volume: - ISSN: 1528-0020 ISO Abbreviation: - Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-7-18 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7603509 Medline TA: Blood Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States; |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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