Role of serum free light chains in predicting HIV-associated non-Hodgkin lymphoma and Hodgkin's lymphoma and its correlation with antiretroviral therapy

Michele Bibas, Maria Paola Trotta, Alessandro Cozzi-Lepri, Patrizia Lorenzini, Carmela Pinnetti, Giuliano Rizzardini, Gioacchino Angarano, Pietro Caramello, Laura Sighinolfi, Claudio Maria Mastroianni, Giovanni Mazzarello, Antonino Di Caro, Cristina Di Giacomo, Antonella d'Arminio Monforte, Andrea Antinori

Research output: Contribution to journalArticlepeer-review

Abstract

A nested case-control study was performed within the Italian cohort of naïve to antiretroviral human immunodeficiency virus (HIV) patients (ICONA) cohort to evaluate the role of serum free light chains (sFLC) in predicting non-Hodgkin's lymphoma (NHL) and Hodgkin lymphoma (HL) in HIV-infected individuals. Of 6513 participants, 86 patients developed lymphoma and 46 of these (NHL, 30; HL, 16) were included in this analysis having stored prediagnostic blood. A total of 46 serum case samples matched 1:1 to lymphoma-free serum control samples were assayed for κ and λ sFLC levels and compared by using conditional logistic regression. Because the polyclonal nature of free light chains (FLCs) was the focus of our study, we introduced the k + λ sum as the measurement of choice and as the primary variable studied. κ + λ sFLC values were significantly higher in patient with lymphoma than in controls, especially when considering samples stored 0-2-year period before the lymphoma diagnosis. In the multivariable analysis, the elevation of sFLC predicted the risk of lymphoma independently of CD4 count, (odd ratio of 16.85 for k + λ sFLC >2-fold upper normal limit (UNL) vs. normal value). A significant reduction in the risk of lymphoma (odd ratio of 0.07 in model with k + λ sFLC) was found in people with low sFLC and undetectable HIV viremia lasting more than 6 months. Our analysis indicates that an elevated polyclonal sFLC is a strong and sensitive predictor of the risk of developing lymphomas, and it is an easy to measure biomarker that merits consideration for introduction in routine clinical practice in people with HIV.

Original languageEnglish
Pages (from-to)749-753
Number of pages5
JournalAmerican Journal of Hematology
Volume87
Issue number8
DOIs
Publication statusPublished - Aug 2012

ASJC Scopus subject areas

  • Hematology

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