title: Extended use of serum free light chain as a biomarker in lymphoproliferative disorders: a comprehensive review.
abstract: Serum free light chain (sFLC) assays were shown to improve detection, management, and prognostication in plasma cell disorders. Recently, sFLC assays improved detection of M proteins when combined with standard methods of protein electrophoresis/immunofixation in patients with non-Hodgkin lymphoma/chronic lymphocytic leukemia (NHL/CLL). Incidence of abnormal sFLC ratio (sFLCr) varied from 0% to 36% and 29.7% to 59% in NHL and CLL, respectively. Increased sFLC levels or abnormal sFLCr predict shorter overall survival in early-stage CLL. Furthermore, abnormal sFLCr correlated with advanced disease stage and poorer outcome. In diffuse large B-cell lymphomas, increased sFLC was demonstrated as an independent, adverse prognostic factor for overall/event-free survival. Moreover, abnormal sFLCr can be a diagnostic tool in central nervous system lymphomas. Finally, the quantitative FLC assay has the potential to become a new, easily measured biomarker for predicting prognosis and enhanced detection in NHL/CLL. It may be used serially at follow-up evaluations to provide clues to relapse.
authors.affiliation: Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Khalil M
authors.initials: KM
authors.lastname: Charafeddine
authors.forename: Mark N
authors.initials: MN
authors.lastname: Jabbour
authors.forename: Raneem H
authors.initials: RH
authors.lastname: Kadi
authors.forename: Rose T
authors.initials: RT
authors.lastname: Daher
mesh_terms: D015415:Biomarkers / Q000097:blood; D018450:Disease Progression; D005260:Female; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000097:blood* / Q000134:cerebrospinal fluid / Q000276:immunology; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000097:blood* / Q000276:immunology; D016483:Lymphoma, AIDS-Related / Q000097:blood / Q000276:immunology; D008232:Lymphoproliferative Disorders / Q000097:blood* / Q000276:immunology; D008297:Male; D010265:Paraproteinemias / Q000097:blood / Q000276:immunology; D011379:Prognosis
chemical_list: D015415:Biomarkers; D007147:Immunoglobulin Light Chains