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The prognostic utility and the association of serum light chains (free and total) and absolute lymphocyte count in patients with newly diagnosed diffuse large B-cell lymphoma
- Elevated sFLC were more frequent than abnormal sTLC in patients with DLBCL.
- Patients with elevated sFLC more frequently showed adverse clinical features.
- Both elevated sFLC andκ/λratio were strongly associated with clinical outcomes.
- Not abnormal sTLC, but elevated sFLC was found to be associated with low ALC.
- sFLC and low ALC remain independent prognostic factors after adjusting for IPI.
In this study, serum free and total light chains (sFLC/sTLC) were measured in 108 serum samples of therapy-naïve patients with DLBCL. Clinicopathologic data and survival outcomes were analyzed according to the results of sFLC/sTLC measurements. Moreover, the association of sFLC/sTLC with absolute monocyte count (AMC) and absolute lymphocyte count (ALC) was evaluated. Elevated sFLC and abnormalκ/λratio was present in 42.6% (51/108) and 4.6% (5/108) of patients, respectively. sTLC was successfully measured in 107 serum samples, abnormal sTLC and abnormalκ/λratio was found in 28.0% (30/107) and 26.2% (28/107) of patients, respectively. Patients with elevated sFLC more frequently displayed adverse clinical characteristics, including age (P = 0.001), B symptoms (P = 0.022), low ALC (P = 0.024) and hyperglobulinemia (P = 0.012). Patients with elevated sFLC had an inferior overall survival (OS) (P = 0.012) and tended to have shorter progression-free survival (PFS) (P = 0.061) compared to patients with normal sFLC. Abnormal sTLC or abnormal sTLC ratio showed no significant association with clinical outcomes, with exception of abnormal concurrentκandλ. Only association of sFLC and ALC with survival remained significant after adjusting for the International Prognostic Index (IPI). The measurement of sFLC and ALC at diagnosis might be useful for the prognostic stratification of patients and sTLC measurement was of little prognostic utility in DLBCL.
Keywords: Diffuse large B cell lymphoma, Free light chains, Total light chains, Absolute monocyte count, Absolute lymphocyte count, Prognostication.
Department of Medical Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China
Corresponding author at: Department of Medical Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. Tel.: +86 10 87788293; fax: +86 10 67705068.
1 These two authors contributed equally to this work.
© 2014 Elsevier Ltd, All rights reserved.