• Xavier Leleu, Wanling Xie, Meghan Bagshaw, Ranjit Banwait, Renee Leduc, Nitin Roper, Edie Weller, and Irene M Ghobrial.
• Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard School of Public Health, Boston, Massachusetts, USA.
• Clin Cancer Res. 2011 May 1; 17 (9): 3013-8.

IntroductionThe serum free light chain (sFLC) has been widely used in the assessment of response in patients with multiple myeloma and other plasma cell dyscrasias. However, its use in Waldenstrom macroglobulinemia (WM) has not been previously assessed. We sought to examine the role of sFLC in response and progression of patients with WM.MethodsThis study was conducted in a cohort of 48 patients with a diagnosis of WM, untreated (n = 20) or relapsed/refractory (n = 28), prospectively treated on a bortezomib and rituximab trial.ResultsInvolved FLC (iFLC) response occurred in 79% patients versus 60% by M-spike protocol criteria. The median time to response was shorter with iFLC than per protocol (2.1 and 3.7 months; P = 0.05). Progression defined using iFLC also correlated well to progression in the protocol (κ = 0.63). However, the median time to progression (TTP) was more rapid by iFLC than per protocol (13.7 and 18.9 months). We also confirmed that a flare in iFLC in post-rituximab therapy did not correlate with lack of response or shorter TTP.ConclusionInvolved sFLC may be a useful marker of tumor measurement, showing earlier response and progression compared with IgM or M-spike measurements.©2011 AACR.

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