title: Abnormal serum free light chain ratio predicts poor overall survival in mantle cell lymphoma.
abstract: Serum free light Chain (sFLC) ratios have been correlated with survival outcomes in Hodgkin and non-Hodgkin lymphoma subtypes. This study was undertaken to investigate the prognostic impact of abnormal sFLC ratios in mantle cell lymphoma (MCL). two patient cohorts were analysed for sFLC parameters: a preliminary retrospective cohort and a uniformly treated cohort of 20 relapsed/refractory MCL patients, enrolled in a phase II clinical trial of single agent lenalidomide treatment. 52% of patients had an abnormality of one or more sFLC parameter (71% of the first cohort and 40% of the second cohort). In cohort two, a high baseline SFLC ratio correlated with poorer overall survival (OS) compared to a low/normal ratio (median OS: 1·4 months vs. 19 months respectively; P = 0·001). For patients presenting with an elevated sFLC ratio at trial entry a rise of >35% in the sFLC ratio correlated with disease progression and a sFLC ratio of >2× normal at trial entry correlated with aggressive disease. These data are the first to show a clear clinical correlation between sFLC ratios and survival outcomes in a uniformly treated cohort of MCL patients. We suggest that these markers may be useful in managing patients with MCL in the future.
authors.affiliation: Department of Haematology, Combined Laboratories, Derriford Hospital, Plymouth, Devon, UK. michelle.furtado@nhs.net
authors.forename: Michelle
authors.initials: M
authors.lastname: Furtado
authors.forename: Nimish
authors.initials: N
authors.lastname: Shah
authors.forename: Alison
authors.initials: A
authors.lastname: Levoguer
authors.forename: Stephen
authors.initials: S
authors.lastname: Harding
authors.forename: Simon
authors.initials: S
authors.lastname: Rule
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood* / Q000276:immunology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000097:blood*; D000077269:Lenalidomide; D020522:Lymphoma, Mantle-Cell / Q000097:blood* / Q000188:drug therapy / Q000235:genetics / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis; D013792:Thalidomide / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D014408:Biomarkers, Tumor; D007147:Immunoglobulin Light Chains; D013792:Thalidomide; D000077269:Lenalidomide