Stężenia w surowicy wolnych lekkich łańcuchów immunoglobulinowych (FLC) i łańcuchów lekkich związanych z łańcuchem ciężkim (HLC), w chwili rozpoznania choroby u chorych na szpiczaka plazmocytowego i chłoniaka złośliwego IgM z czasem przeżycia ponad 10 lat

Abstract

Immunoglobulin (Ig) heavy/light chain (HLC) is a novel antibody based assay that separately measures in pairs the light chain types of each ig class generating ratios of monoclonal ig/background polyclonal ig concentrations. Free light chain (FLC) assay measures unbound κ and λ chains. The aim of the present study was to assess the prognostic impact of HLC and FLC assays in multiple myeloma (MM) and IGM malignant lymphoma (ML) patients with real long term survival. Measurements of serum HLC and FLC concentrations were performed in 23 MM and 12 ML patients with survival exceeding 10 years and 43 (19 MM, 24 ML) patients with survival not exceeding 5 years. HLC and FLC ratios at diagnosis were less abnormal in patients with survival exceeding 10 years than in patients with survival up to 5 years (p=0.03). The differences in median values were manifold. However, in patients with survival over 10 years highly abnormal HLC ratio (<0.022 or >45) was found in 3 mm patients and 7 ml patients and highly abnormal FLC ratio (<0.1 or >30) was found in 5 mm patients and in 1 ml patient. In conclusion, serum HLC and FLC measurements at mm diagnosis provide prognostic information, despite that even in mm patients with survival exceeding 10 years in 15% of them at diagnosis serum HLC and FLC ratios may be highly abnormal.