title: Immunoglobulin heavy chain/light chain pair measurement is associated with survival in diffuse large B-cell lymphoma.
abstract: Elevated serum free light chains (FLCs) have been associated with an unfavorable prognosis in diffuse large B-cell lymphoma (DLBCL). The aim of this study was to determine the clinical relevance of a quantitative assessment of intact circulating immunoglobulin (Ig), using serum Ig heavy chain/light chain pair (HLC) measurements in patients with DLBCL. FLC and HLC were measured in 409 serum samples of patients with DLBCL included in the LNH03-B clinical trial program of the Groupe d'Etudes des Lymphomes de l'Adulte (GELA). Patients with an abnormal IgMκ/IgMλ ratio or an abnormal FLC ratio more frequently displayed adverse clinical characteristics. Patients with abnormal IgMκ/IgMλ ratios had inferior progression-free survival (PFS) and overall survival (OS) as compared to patients with a normal ratio in the overall cohort (5-year PFS 44.9% vs. 69.3%, p = 0.0003 and 5-year OS 50.8% vs. 78.1%, p = 0.0003) and in the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) cohort (5-year OS 43.5% vs. 70.3%, p = 0.003). In multivariate analysis, including elevated FLC/HLC and International Prognostic Index (IPI), an abnormal IgMκ/IgMλ ratio (hazard ratio [HR] = 1.54, 95% confidence interval [CI] 1.03-2.3, p = 0.03) remained predictive of shorter progression-free survival. Gene expression profile experiments and immunohistochemistry indicate that this measurement is at least partially related to tumor cell secretion. Both elevated serum FLCs and an abnormal IgMκ/IgMλ ratio are associated with unfavorable outcomes in patients with DLBCL treated by R-CHOP.
authors: Department of Hematology and INSERM U918, IRIB, Centre Henri Becquerel, Rouen, France. fabrice.jardin@chb.unicancer.fr
authors: Fabrice
authors: F
authors: Jardin
authors: Marie Hélène
authors: MH
authors: Delfau-Larue
authors: Thierry Jo
authors: TJ
authors: Molina
authors: Christiane
authors: C
authors: Copie-Bergman
authors: Josette
authors: J
authors: Brière
authors: Tony
authors: T
authors: Petrella
authors: Danielle
authors: D
authors: Canioni
authors: Bettina
authors: B
authors: Fabiani
authors: Jean-Philippe
authors: JP
authors: Jais
authors: Martin
authors: M
authors: Figeac
authors: Karen
authors: K
authors: Leroy
authors: Sylvain
authors: S
authors: Mareschal
authors: Gilles André
authors: GA
authors: Salles
authors: Bertrand
authors: B
authors: Coiffier
authors: Richard
authors: R
authors: Delarue
authors: Frédéric
authors: F
authors: Peyrade
authors: André
authors: A
authors: Bosly
authors: Marc
authors: M
authors: André
authors: Nicolas
authors: N
authors: Ketterer
authors: Corinne
authors: C
authors: Haioun
authors: Hervé
authors: H
authors: Tilly
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000097:blood*; D007132:Immunoglobulin Isotypes / Q000097:blood; D007147:Immunoglobulin Light Chains / Q000097:blood*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D016016:Proportional Hazards Models; D000069283:Rituximab; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007143:Immunoglobulin Heavy Chains; D007132:Immunoglobulin Isotypes; D007147:Immunoglobulin Light Chains; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone