TY - JOUR
T1 - Use of nonclonal serum immunoglobulin free light chains to predict overall survival in the general population
AU - Dispenzieri, Angela
AU - Katzmann, Jerry A.
AU - Kyle, Robert A.
AU - Larson, Dirk R.
AU - Therneau, Terry M.
AU - Colby, Colin L.
AU - Clark, Raynell J.
AU - Mead, Graham P.
AU - Kumar, Shaji
AU - Melton, L. Joseph
AU - Rajkumar, S. Vincent
N1 - Funding Information:
Grant Support: This work was supported in part by grants CA62242 (A.D, R.A.K. S.V.R.), CA107476 (A.D., S.V.R., J.A.K., R.A.K.), and CA91561 (A.D) from the National Cancer Institute , The JABBS Foundation , and The Predolin Foundation . Binding Site provided the serum immunoglobulin free light chain reagent. This study was supported in part by National Institutes of Health grant R01 AG034676 and the Rochester Epidemiology Project (grant number R01-AG034676 ; Principal Investigator: Walter A. Rocca, MD).
PY - 2012/6
Y1 - 2012/6
N2 - Objective: To determine whether the free light chain (FLC) assay provides prognostic information relevant to the general population. Methods: After excluding persons with a known plasma cell disorder, we studied 15,859 Olmsted County, Minnesota, residents 50 years or older in whom unmasked data and samples for FLC testing were available. Baseline information was obtained between March 13, 1995, and November 21, 2003, and follow-up status and cause of death were identified through June 30, 2009. The κ and γ FLC sum (Σ FLC) was evaluated for its ability to predict overall survival. Specific causes of death were also investigated. Results: In 158,003 person-years of follow-up, 4348 individuals died. A high Σ FLC was significantly predictive of worse overall survival; the risk ratio for death for those with the highest decile of Σ FLC (ie,≥4.72 mg/dL) was 4.4 (95% confidence interval, 4.1-4.7) relative to the remaining study participants. Multivariate analyses demonstrated that this excess risk of death was independent of age, sex, and renal insufficiency, with a corrected risk ratio of 2.1 (95% confidence interval, 1.9-2.2). The increased mortality was not restricted to any particular cause of death because the observed-to-expected risk of death from most causes was significantly higher among those individuals with an antecedent Σ FLC of 4.72 mg/dL or higher, which is near the upper limit of normal for the test. Conclusion: A nonclonal elevation of Σ FLC is a significant predictor of worse overall survival in the general population of persons without plasma cell disorders.
AB - Objective: To determine whether the free light chain (FLC) assay provides prognostic information relevant to the general population. Methods: After excluding persons with a known plasma cell disorder, we studied 15,859 Olmsted County, Minnesota, residents 50 years or older in whom unmasked data and samples for FLC testing were available. Baseline information was obtained between March 13, 1995, and November 21, 2003, and follow-up status and cause of death were identified through June 30, 2009. The κ and γ FLC sum (Σ FLC) was evaluated for its ability to predict overall survival. Specific causes of death were also investigated. Results: In 158,003 person-years of follow-up, 4348 individuals died. A high Σ FLC was significantly predictive of worse overall survival; the risk ratio for death for those with the highest decile of Σ FLC (ie,≥4.72 mg/dL) was 4.4 (95% confidence interval, 4.1-4.7) relative to the remaining study participants. Multivariate analyses demonstrated that this excess risk of death was independent of age, sex, and renal insufficiency, with a corrected risk ratio of 2.1 (95% confidence interval, 1.9-2.2). The increased mortality was not restricted to any particular cause of death because the observed-to-expected risk of death from most causes was significantly higher among those individuals with an antecedent Σ FLC of 4.72 mg/dL or higher, which is near the upper limit of normal for the test. Conclusion: A nonclonal elevation of Σ FLC is a significant predictor of worse overall survival in the general population of persons without plasma cell disorders.
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U2 - 10.1016/j.mayocp.2012.03.009
DO - 10.1016/j.mayocp.2012.03.009
M3 - Article
C2 - 22677072
AN - SCOPUS:84863442192
SN - 0025-6196
VL - 87
SP - 517
EP - 523
JO - Mayo Clinic proceedings
JF - Mayo Clinic proceedings
IS - 6
ER -