Monoclonal and polyclonal serum free light chains and clinical outcome in chronic lymphocytic leukemia

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 Elliot Kay, Susan L Slager, Thomas Elmer Witzig, Tait D. Shanafelt

Research output: Contribution to journalArticle

33 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)2821-2826
Number of pages6
JournalBlood
Volume118
Issue number10
DOIs
StatePublished - Sep 8 2011

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B-Cell Chronic Lymphocytic Leukemia
Light
Serum
Hazards
Biomarkers
Confidence Intervals
Assays
Paraproteins

ASJC Scopus subject areas

  • Hematology
  • Biochemistry
  • Cell Biology
  • Immunology

Cite this

Maurer, M. J., Cerhan, J. R., Katzmann, J. A., Link, B. K., Allmer, C., Zent, C. S., ... Shanafelt, T. D. (2011). Monoclonal and polyclonal serum free light chains and clinical outcome in chronic lymphocytic leukemia. Blood, 118(10), 2821-2826. https://doi.org/10.1182/blood-2011-04-349134

Monoclonal and polyclonal serum free light chains and clinical outcome in chronic lymphocytic leukemia. / Maurer, Matthew J.; Cerhan, James R; Katzmann, Jerry A.; Link, Brian K.; Allmer, Cristine; Zent, Clive S.; Call, Timothy G.; Rabe, Kari G.; Hanson, Curtis A.; Kay, Neil Elliot; Slager, Susan L; Witzig, Thomas Elmer; Shanafelt, Tait D.

In: Blood, Vol. 118, No. 10, 08.09.2011, p. 2821-2826.

Research output: Contribution to journalArticle

Maurer, MJ, Cerhan, JR, Katzmann, JA, Link, BK, Allmer, C, Zent, CS, Call, TG, Rabe, KG, Hanson, CA, Kay, NE, Slager, SL, Witzig, TE & Shanafelt, TD 2011, 'Monoclonal and polyclonal serum free light chains and clinical outcome in chronic lymphocytic leukemia', Blood, vol. 118, no. 10, pp. 2821-2826. https://doi.org/10.1182/blood-2011-04-349134
Maurer, Matthew J. ; Cerhan, James R ; Katzmann, Jerry A. ; Link, Brian K. ; Allmer, Cristine ; Zent, Clive S. ; Call, Timothy G. ; Rabe, Kari G. ; Hanson, Curtis A. ; Kay, Neil Elliot ; Slager, Susan L ; Witzig, Thomas Elmer ; Shanafelt, Tait D. / Monoclonal and polyclonal serum free light chains and clinical outcome in chronic lymphocytic leukemia. In: Blood. 2011 ; Vol. 118, No. 10. pp. 2821-2826.
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