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Blood Cancer J. 2019 Aug 5;9(8):59. doi: 10.1038/s41408-019-0220-x.

Association of elevated serumfree light chains with chronic lymphocytic leukemia and monoclonal B-cell lymphocytosis.

Author information

1
Division of Epidemiology, Department of Health Sciences, Mayo Clinic, Rochester, MN, USA.
2
Department of Internal Medicine, Mercy Hospital, St. Louis, MO, USA.
3
Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA.
4
Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA.
5
Division of Hematology, Mayo Clinic, Rochester, MN, 55905, USA.
6
Stanford University Medical Center, Department of Medicine/Hematology, Stanford, CA, USA.
7
Duke University and V.A. Medical Centers, Durham, NC, USA.
8
Department of Medicine, University of Utah and Huntsman Cancer Institute, Salt Lake City, UT, USA.
9
Division of Medical Oncology, Mayo Clinic, Phoenix, AZ, USA.
10
Laboratory Medicine and Pathology, College of Medicine, Mayo Clinic, Rochester, MN, 55905, USA.
11
Myeloma Service, Division of Hematologic Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
12
Division of Epidemiology, Department of Health Sciences, Mayo Clinic, Rochester, MN, USA. vachon.celine@mayo.edu.

Abstract

Chronic lymphocytic leukemia (CLL) and its precursor, monoclonal B-cell lymphocytosis (MBL), are heritable. Serumfree light-chain (sFLC) measures are a prognostic factor for CLL, but their role in susceptibility to CLL is not clear. We investigated differences between sFLC measurements in pre-treatment serum from five groups to inform the association of sFLC with familial and sporadic CLL: (1) familial CLL (n = 154), (2) sporadic CLL (n = 302), (3) familial MBL (n = 87), (4) unaffected first-degree relatives from CLL/MBL families (n = 263), and (5) reference population (n = 15,396). The percent of individuals having elevated monoclonal and polyclonal sFLCs was compared using age-stratified and age- and sex-adjusted logistic regression models. In age groups >50 years, monoclonal sFLC elevations were increased in sporadic and familial CLL cases compared to the reference population (p's < 0.05). However, there were no statistically significant differences in sFLC monoclonal or polyclonal elevations between familial and sporadic CLL cases (p's > 0.05). Unaffected relatives and MBL cases from CLL/MBL families, ages >60 years, showed elevated monoclonal sFLC, compared to the reference population (p's < 0.05). This is the first study to demonstrate monoclonal sFLC elevations in CLL cases compared to controls. Monoclonal sFLC levels may provide additional risk information in relatives of CLL probands.

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