Sylvain Mareschal, Ph.D.
Bioinformatics engineer
February 18, 2013 at 23:54
Jardin et al, Leuk Lymphoma 2013
Leuk Lymphoma. 2013 Sep;54(9):1898-907.
doi: 10.3109/10428194.2013.767456.
Epub 2013 Feb 18.

Immunoglobulin heavy chain / light chain pair measurement is associated with survival in Diffuse Large B-Cell Lymphoma.

Jardin F, Delfau-Larue MH, Molina TJ, Copie-Bergman C, Brière J, Petrella T, Canioni D, Fabiani B, Jais JP, Figeac M, Leroy K, Mareschal S, André Salles G, Coiffier B, Delarue R, Peyrade F, Bosly A, André M, Ketterer N, Haioun C, Tilly H.

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 IgM?/IgM? ratio or an abnormal FLC ratio more frequently displayed adverse clinical characteristics. Patients with abnormal IgM?/IgM? 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 IgM?/IgM? 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 IgM?/IgM? ratio are associated with unfavorable outcomes in patients with DLBCL treated by R-CHOP.

Pubmed, PMID: 23327290