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CC BY-NC-ND 4.0 · South Asian J Cancer 2022; 11(03): 256-259
DOI: 10.1055/s-0042-1743426
Original Article
Lymphoma and Myeloma

Serum Free Light Chain Assay as a Prognostic Marker in Patients with Aggressive B-Cell Non-Hodgkin's Lymphoma: Impact on Survival Outcome

T.M. Anoop 
1   Department of Medical Oncology, Regional Cancer Center, Thiruvananthapuram, Kerala, India
,
Geetha Narayanan 
1   Department of Medical Oncology, Regional Cancer Center, Thiruvananthapuram, Kerala, India
,
Steffi Chacko
1   Department of Medical Oncology, Regional Cancer Center, Thiruvananthapuram, Kerala, India
,
K.M. Jagathnath Krishna 
2   Department of Epidemiology and Biostatistics, Regional Cancer Center, Thiruvananthapuram, Kerala, India
,
Sreejith G. Nair
1   Department of Medical Oncology, Regional Cancer Center, Thiruvananthapuram, Kerala, India
› Author Affiliations Funding There are no sources of funding for this work and there are no competing interests among the authors.
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Abstract

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T.M. Anoop

Background The role of serum free light chain (FLC) as a prognostic biomarker in lymphoproliferative diseases is being increasingly studied. In this study we present the 5-year survival outcome for patients with aggressive B-cell non-Hodgkin's lymphoma (NHL) and their relation to FLC and other known prognostic markers.

Materials and Methods This is a prospective study conducted in patients diagnosed with aggressive B-cell NHL. Serum FLC level and ratio were estimated prior to initiation of treatment.

Results A total of 100 patients were included in the study from December 2013 to December 2015 with a median age of 53 years. Thirty-eight patients (38%) had elevated FLC level of which 26% were polyclonal and 12% were monoclonal elevations. Abnormal FLC ratio was noted in 12% patients. Median follow-up duration of the study was 75 months. Five-year relapse-free survival (RFS) for the study population was 54.4%. Five-year RFS was 64.1% for early stage and 48.2% for advanced stage diseases (p = 0.05). The RFS was significantly better in age less than 60 years (59.5% vs 43.8%, p < 0.001). Five-year overall survival (OS) was 61.3%. OS was significantly better in younger patients (73.6% vs 33.4%, p < 0.001), with International Prognosis Index score of 0 to 2 (87.4% vs 26.7%, p < 0.001). Patients with elevated FLC had inferior RFS (50% vs 71.4%, p = 0.04). Abnormal FLC ratio also strongly corresponded to inferior RFS (54.5% vs 66.2%, p = 0.001). OS was also significantly inferior in patients with abnormal FLC ratio (72.6% vs 63.6%, p = 0.001).

Conclusion In patients with newly diagnosed aggressive B-cell NHL, elevated FLC levels and abnormal FLC ratio were significantly associated with inferior survival.

Keywords

free light chain - non-Hodgkin's lymphoma - survival - aggressive B-cell NHL - prognostic biomarker

Authors' Contributions

TMA and GN designed the study, collected the data, and wrote the article. SC, KMJK, and SGN also contributed to data collection, performed the analysis, and reviewed the final manuscript. All the authors equally contributed to this work.


Declaration

This manuscript has been read and approved by all the authors. Each author believes this manuscript represents honest work and the requirements of authorship have been met.


Supplementary Material



Publication History

Article published online:
25 April 2022

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