Detection of the value of consecutive serum total light chain (sTLC) in patients diagnosed with diffuse large B cell lymphoma

• Published in: Annals of hematology 2016-12, Vol.95 (12), p.1999-2007
• Main Authors: Zhai, Linzhu, Zhao, Yuanyuan, Peng, Songguo, Zhu, Ke, Yu, Rongjian, Chen, Hailong, Lin, Tongyu, Lin, Lizhu
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal, Murine-Derived - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Biomarkers - blood; Cyclophosphamide - administration & dosage; Doxorubicin - administration & dosage; Female; Follow-Up Studies; Hematology; Humans; Immunoglobulin gamma-Chains - blood; Immunoglobulin kappa-Chains - blood; Lymphoma, Large B-Cell, Diffuse - blood; Lymphoma, Large B-Cell, Diffuse - diagnosis; Lymphoma, Large B-Cell, Diffuse - drug therapy; Male; Medicine; Medicine & Public Health; Middle Aged; Oncology; Original Article; Prednisone - administration & dosage; Vincristine - administration & dosage
• ISSN: 0939-5555; 1432-0584
• DOI: 10.1007/s00277-016-2794-8

There are limited data on serum total light chain (sTLC) in lymphoma and its relative role on the outcome of diffuse large B cell lymphoma (DLBCL) patients. Blood samples from 46 cases newly diagnosed with DLBCL were collected consecutively during chemotherapy to detect sTLC, IgG, IgA, and IgM levels. Clinical data and survival outcomes were analyzed according to the results of sTLC measurements. In summary, 22 patients (47.8 %) had abnormal k or λ light chain, respectively, and 6 patients (13.0 %) had both abnormal k and λ light chains before chemotherapy. Patients with elevated k light chain more frequently displayed multiple extra-nodal organ involvement ( P  = 0.01) and had an inferior overall survival (OS) ( P  = 0.041) and progression-free survival (PFS) ( P  = 0.044) compared to patients with normal level of k light chain. Furthermore, patients with elevated level of both k and λ also exhibited significant association with shorter OS ( P  = 0.002) and PFS ( P  = 0.009). Both elevated k alone and concurrent elevated k and λ had independent adverse effects on PFS ( P  = 0.031 and P  = 0.019, respectively). sTLC level was reduced gradually by treatment in this study and reached the lowest point after the fourth cycle of chemotherapy, which was consistent with the disease behavior during chemotherapy. Considering the small sample size of this study, these results should be confirmed in a larger prospective study.