Serum-free light chain-a new biomarker for patients with B-cell non-Hodgkin lymphoma and chronic lymphocytic leukemia

William Martin, Roshini Abraham, Tait Shanafelt, Raynell J. Clark, Nancy Bone, Susan M. Geyer, Jerry A. Katzmann, Arthur Bradwell, Neil E. Kay, Thomas E. Witzig

Research output: Contribution to journalArticlepeer-review

54 Scopus citations


New nephelometric immunoassays specific for free immunoglobulin light chains (FLCs) improve detection of monoclonal proteins (M-protein). Initial studies with FLC have focused on multiple myeloma and amyloidosis. The goal of this study was to evaluate the frequency of monoclonal serum FLC in patients with other B-cell malignancies. Frozen sera from 226 patients with non-Hodgkin lymphoma (NHL) or chronic lymphocytic leukemia (CLL) were tested for M-protein by the serum FLC assay and compared with standard protein electrophoresis (PEL) and immunofixation (IF). Overall, 24% (54/226) of samples had a detectable M-protein with 63% of these (34/54) FLC-positive. In 35% (19/54), the M-protein was only detectable by FLC analysis. Of the 208 NHL patients, 22% (46/208) had a detectable M-protein. Also, 13% (27/208) were positive for FLC and 16% (33/208) had a detectable M-protein by PEL/IF. Twenty-eighty percent (13/46) of NHL patients with M-proteins were detectable only by FLC analysis. Within NHL, the highest incidences of FLC presence were in patients with mantle cell (36%) and small lymphocytic (24%). Among CLL patients, 44% had an M-protein with 39% detected by FLC and 11% detected by PEL/IF. Notably, in 6 of 8 CLL patients, the M-protein was only detectable by the FLC method. Serum FLC can be detected in a substantial fraction of patients with NHL/CLL, and the FLC technique improves detection of M-proteins when combined with standard PEL/IF. Future studies are warranted to elucidate the role of serum FLC as biomarkers of disease, for monitoring of minimal residual disease, and as a prognostic factor for response and survival.

Original languageEnglish (US)
Pages (from-to)231-235
Number of pages5
JournalTranslational Research
Issue number4
StatePublished - Apr 2007

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Biochemistry, medical
  • Physiology (medical)


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