The Correlation between the Serum Level of Free Light Chain Ratio and Prognostic Factors among the Patients with Lymphoma

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Hematology Subspecialty Resident, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Community Medicine Specialist, Cancer Prevention Research Center, Isfahan University of Medical Sciences, Isfahan Iran

Abstract

Background: Non-Hodgkin lymphoma is the most common cancer in the world. This study aimed to determine the correlation between the serum level of free light chain ratio and age, and subtype and stage of the disease.Methods: In a cross-sectional study, 59 patients with lymphoma who presented to Seyyed-al-Shohada hospital, Isfahan, Iran, were investigated. Subtype and stage of disease were specified via clinical exam and histologic and radiologic studies. Prognostic laboratory factors such as B2-microglobulin (B2MG), albumin, lactate dehydrogenase (LDH) and (ESR), in addition to serum free light chain (kappa and lambda) using nephelometry method were measured. The data were analyzed using SPSS softwareFindings: There was no relationship between the mean serum level of free light chains and B2-microglobulin (P = 0.193, r = 0.173, and P = 0.170, r = 0.181 for lambda and kappa chains, respectively). Mean serum level of lambda chain was higher among the patients with bone marrow involvement and B-symptoms (fever, night sweats, and weight loss) (P = 0.021), but the mean serum level of albumin was lower among these patients (P = 0.025).Conclusion: In patients with bone marrow involvement and presence of B-symptoms, only serum lambda levels were higher than those without it. There were no correlation between the level of serum free light chain ratio and age, and subtype and stage of disease.

Keywords

References

  1. Bradwell AR, Carr-Smith HD, Mead GP, Tang LX, Showell PJ, Drayson MT, et al. Highly sensitive, automated immunoassay for immunoglobulin free light chains in serum and urine. Clin Chem 2001; 47(4): 673-80.
  2. Katzmann JA, Abraham RS, Dispenzieri A, Lust JA, Kyle RA. Diagnostic performance of quantitative kappa and lambda free light chain assays in clinical practice. Clin Chem 2005; 51(5): 878-81.
  3. Dingli D, Kyle RA, Rajkumar SV, Nowakowski GS, Larson DR, Bida JP, et al. Immunoglobulin free light chains and solitary plasmacytoma of bone. Blood 2006; 108(6): 1979-83.
  4. Rajkumar SV, Kyle RA, Therneau TM, Melton LJ 3rd, Bradwell AR, Clark RJ, et al. Serum free light chain ratio is an independent risk factor for progression in monoclonal gammopathy of undetermined significance. Blood 2005; 106(3): 812-7.
  5. Abraham RS, Katzmann JA, Clark RJ, Bradwell AR, Kyle RA, Gertz MA. Quantitative analysis of serum free light chains. A new marker for the diagnostic evaluation of primary systemic amyloidosis. Am J Clin Pathol 2003; 119(2): 274-8.
  6. Dispenzieri A, Kyle R, Merlini G, Miguel JS, Ludwig H, Hajek R, et al. International Myeloma Working Group guidelines for serum-free light chain analysis in multiple myeloma and related disorders. Leukemia 2009; 23(2): 215-24.
  7. Dispenzieri A, Lacy MQ, Katzmann JA, Rajkumar SV, Abraham RS, Hayman SR, et al. Absolute values of immunoglobulin free light chains are prognostic in patients with primary systemic amyloidosis undergoing peripheral blood stem cell transplantation. Blood 2006; 107(8): 3378-83.
  8. Martin W, Abraham R, Shanafelt T, Clark RJ, Bone N, Geyer SM, et al. Serum-free light chain-a new biomarker for patients with B-cell non-Hodgkin lymphoma and chronic lymphocytic leukemia. Transl Res 2007; 149(4): 231-5.
  9. Yegin ZA, Ozkurt ZN, Yagci M. Free light chain: A novel predictor of adverse outcome in chronic lymphocytic leukemia. Eur J Haematol 2010; 84(5): 406-11.
  10. Furtado M, Shah N, Levoguer A, Harding S, Rule S. Abnormal serum free light chain ratio predicts poor overall survival in mantle cell lymphoma. Br J Haematol 2013; 160(1): 63-9.
  11. Thompson CA, Maurer MJ, Cerhan JR, Katzmann JA, Ansell SM, Habermann TM, et al. Elevated serum free light chains are associated with inferior event free and overall survival in Hodgkin lymphoma. Am J Hematol 2011; 86(12): 998-1000.
  12. Maurer MJ, Micallef IN, Cerhan JR, Katzmann JA, Link BK, Colgan JP, et al. 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. J Clin Oncol 2011; 29(12): 1620-6.
  13. Pratt G, Harding S, Holder R, Fegan C, Pepper C, Oscier D, et al. Abnormal serum free light chain ratios are associated with poor survival and may reflect biological subgroups in patients with chronic lymphocytic leukaemia. Br J Haematol 2009; 144(2): 217-22.
  14. Shustik C, Harding S, Ding K, Zhu L, Rassenti LZ, Kipps TJ, et al. Analysis of the Serum Free Light Chain Ratio and Its Prognostic Value in a Cohort of Patients with Chronic Lymphocytic Leukemia. Blood 2009; 114(22): 2631.
  15. Morabito F, De FR, Laurenti L, Zirlik K, Recchia AG, Gentile M, et al. The cumulative amount of serum-free light chain is a strong prognosticator in chronic lymphocytic leukemia. Blood 2011; 118(24): 6353-61.
  16. Sarris K, Maltezas D, Koulieris E, Bartzis V, Tzenou T, Sachanas S, et al. Prognostic significance of serum free light chains in chronic lymphocytic leukemia. Adv Hematol 2013; 2013: 359071.
  17. Moghimi M, Kashkooli BM, Maghbooli M, Jafari S, Mazloomzadeh S, Pezeshgi A. Association between abnormal serum free light chains ratio and known prognostic factors in lymphoma; a nephrology viewpoint. J Renal Inj Prev 2017; 6(2): 148-52.
Journal of Isfahan Medical School
Volume 36, Issue 467 - Serial Number 467
January and February 2018
Pages 96-103

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History

  • Receive Date: 15 January 2018
  • Revise Date: 02 November 2024
  • Accept Date: 06 April 2022

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