Abnormal serum free light chain ratio predicts poor overall survival in mantle cell lymphoma

Br J Haematol. 2013 Jan;160(1):63-9. doi: 10.1111/bjh.12094. Epub 2012 Oct 24.


Serum free light Chain (sFLC) ratios have been correlated with survival outcomes in Hodgkin and non-Hodgkin lymphoma subtypes. This study was undertaken to investigate the prognostic impact of abnormal sFLC ratios in mantle cell lymphoma (MCL). two patient cohorts were analysed for sFLC parameters: a preliminary retrospective cohort and a uniformly treated cohort of 20 relapsed/refractory MCL patients, enrolled in a phase II clinical trial of single agent lenalidomide treatment. 52% of patients had an abnormality of one or more sFLC parameter (71% of the first cohort and 40% of the second cohort). In cohort two, a high baseline SFLC ratio correlated with poorer overall survival (OS) compared to a low/normal ratio (median OS: 1·4 months vs. 19 months respectively; P = 0·001). For patients presenting with an elevated sFLC ratio at trial entry a rise of >35% in the sFLC ratio correlated with disease progression and a sFLC ratio of >2× normal at trial entry correlated with aggressive disease. These data are the first to show a clear clinical correlation between sFLC ratios and survival outcomes in a uniformly treated cohort of MCL patients. We suggest that these markers may be useful in managing patients with MCL in the future.

MeSH terms

  • Adult
  • Aged
  • Biomarkers, Tumor / blood*
  • Biomarkers, Tumor / immunology
  • Cohort Studies
  • Female
  • Humans
  • Immunoglobulin Light Chains / blood*
  • Lenalidomide
  • Lymphoma, Mantle-Cell / blood*
  • Lymphoma, Mantle-Cell / drug therapy
  • Lymphoma, Mantle-Cell / genetics
  • Lymphoma, Mantle-Cell / immunology
  • Male
  • Middle Aged
  • Prognosis
  • Survival Analysis
  • Thalidomide / analogs & derivatives
  • Thalidomide / therapeutic use


  • Biomarkers, Tumor
  • Immunoglobulin Light Chains
  • Thalidomide
  • Lenalidomide