Extended use of serum free light chain as a biomarker in lymphoproliferative disorders: a comprehensive review

Am J Clin Pathol. 2012 Jun;137(6):890-7. doi: 10.1309/AJCP4INKZ6LYAQXW.


Serum free light chain (sFLC) assays were shown to improve detection, management, and prognostication in plasma cell disorders. Recently, sFLC assays improved detection of M proteins when combined with standard methods of protein electrophoresis/immunofixation in patients with non-Hodgkin lymphoma/chronic lymphocytic leukemia (NHL/CLL). Incidence of abnormal sFLC ratio (sFLCr) varied from 0% to 36% and 29.7% to 59% in NHL and CLL, respectively. Increased sFLC levels or abnormal sFLCr predict shorter overall survival in early-stage CLL. Furthermore, abnormal sFLCr correlated with advanced disease stage and poorer outcome. In diffuse large B-cell lymphomas, increased sFLC was demonstrated as an independent, adverse prognostic factor for overall/event-free survival. Moreover, abnormal sFLCr can be a diagnostic tool in central nervous system lymphomas. Finally, the quantitative FLC assay has the potential to become a new, easily measured biomarker for predicting prognosis and enhanced detection in NHL/CLL. It may be used serially at follow-up evaluations to provide clues to relapse.

Publication types

  • Review

MeSH terms

  • Biomarkers / blood
  • Disease Progression
  • Female
  • Humans
  • Immunoglobulin Light Chains / blood*
  • Immunoglobulin Light Chains / cerebrospinal fluid
  • Immunoglobulin Light Chains / immunology
  • Leukemia, Lymphocytic, Chronic, B-Cell / blood*
  • Leukemia, Lymphocytic, Chronic, B-Cell / immunology
  • Lymphoma, AIDS-Related / blood
  • Lymphoma, AIDS-Related / immunology
  • Lymphoproliferative Disorders / blood*
  • Lymphoproliferative Disorders / immunology
  • Male
  • Paraproteinemias / blood
  • Paraproteinemias / immunology
  • Prognosis


  • Biomarkers
  • Immunoglobulin Light Chains