Prognostic significance of serum free radical level in head injury

2005 ◽  
Vol 2 (2) ◽  
pp. 107-109
Author(s):  
A. Mishra ◽  
M.F. Huda ◽  
V.P. Singh ◽  
S. Mohanty ◽  
A. Sodhi
Keyword(s):  
Free Radical ◽  
Head Injury ◽  
Prognostic Significance ◽  
Serum Free

scholarly journals High serum-free light chain levels and their rapid reduction in response to therapy define an aggressive multiple myeloma subtype with poor prognosis

Blood ◽  
2007 ◽  
Vol 110 (3) ◽  
pp. 827-832 ◽  
Author(s):  
Frits van Rhee ◽  
Vanessa Bolejack ◽  
Klaus Hollmig ◽  
Mauricio Pineda-Roman ◽  
Elias Anaissie ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Light Chain ◽  
Prognostic Significance ◽  
Complete Response ◽  
High Serum ◽  
Free Light Chain ◽  
Response To Therapy ◽  
Rapid Reduction ◽  
Serum Free ◽  
Serum Free Light Chain

Abstract Serum-free light chain (SFLC) levels are useful for diagnosing nonsecretory myeloma and monitoring response in light-chain–only disease, especially in the presence of renal failure. As part of a tandem autotransplantation trial for newly diagnosed multiple myeloma, SFLC levels were measured at baseline, within 7 days of starting the first cycle, and before both the second induction cycle and the first transplantation. SFLC baseline levels higher than 75 mg/dL (top tertile) identified 33% of 301 patients with higher near-complete response rate (n-CR) to induction therapy (37% vs 20%, P = .002) yet inferior 24-month overall survival (OS: 76% vs 91%, P < .001) and event-free survival (EFS: 73% vs 90%, P < .001), retaining independent prognostic significance for both EFS (HR = 2.40, P = .008) and OS (HR = 2.43, P = .016). Baseline SFLC higher than 75 mg/dL was associated with light-chain–only secretion (P < .001), creatinine level 176.8 μM (2 mg/dL) or higher (P < .001), beta-2-microglobulin 297.5 nM/L (3.5 mg/L) or higher (P < .001), lactate dehydrogenase 190 U/L or higher (P < .001), and bone marrow plasmacytosis higher than 30% (P = .003). Additional independent adverse implications were conferred by top-tertile SFLC reductions before cycle 2 (OS: HR = 2.97, P = .003; EFS: HR = 2.56, P = .003) and before transplantation (OS: HR = 3.31, P = .001; EFS: HR = 2.65, P = .003). Unlike baseline and follow-up analyses of serum and urine M-proteins, high SFLC levels at baseline—reflecting more aggressive disease—and steeper reductions after therapy identified patients with inferior survival.

Long-term neuropsychological outcome of closed head injury

1979 ◽  
Vol 50 (4) ◽  
pp. 412-422 ◽  
Author(s):  
Harvey S. Levin ◽  
Robert G. Grossman ◽  
James E. Rose ◽  
Graham Teasdale
Keyword(s):  
Head Injury ◽  
Social Adjustment ◽  
Prognostic Significance ◽  
Closed Head Injury ◽  
Memory Storage ◽  
Acute Injury ◽  
Closed Head ◽  
Disabled Patients

✓ Long-term recovery from severe closed head injury was investigated in predominantly young adults whose Glasgow Coma score was 8 or less at the time of admission. Of the 27 patients studied (median follow-up interval of 1 year), 10 attained a good recovery, 12 were moderately disabled, and five were severely disabled. In contrast to previous studies suggesting that intellectual ability after severe closed head injury eventually recovers to a normal level, our findings showed that residual intellectual level, memory storage and retrieval, linguistic deficit, and personal social adjustment corresponded to overall outcome. All severely disabled patients and several moderately disabled patients exhibited unequivocal cognitive and emotional sequelae after long follow-up intervals. Analysis of persistent neuropsychological deficit in relation to neurological indices of acute injury severity demonstrated the prognostic significance of oculovestibular deficit.

Serum Free Light Chain Measurement in Myeloma Patient Samples with Oligoclonal Protein Bands.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 5044-5044
Author(s):  
Regina Stein ◽  
Jayesh Mehta ◽  
Eric Vickrey ◽  
William Resseguie ◽  
Seema Singhal
Keyword(s):  
Disease Activity ◽  
Serum Protein ◽  
Light Chain ◽  
Prognostic Significance ◽  
Inactive Disease ◽  
Oligoclonal Bands ◽  
Current Therapy ◽  
Light Chains ◽  
Serum Free ◽  
Monoclonal Protein

Abstract During or after therapy, patients with myeloma sometimes develop multiple protein bands that are detectable on urine/serum protein immunofixation. These so-called “oligoclonal bands” may or may not include the original monoclonal protein isotype. The phenomenon is thought to represent immune recovery with no adverse prognostic significance. Estimation of serum free light chains (SFLC) is useful in selected patients with non-secretory myeloma, and in light chain disease with anuric renal failure. The normal serum free κ:λ ratio (SFKLR) is 0.26–1.65. There are no data on SFLC levels and SFKLR in patients with oligoclonal bands. We analyzed 52 samples in 23 patients (1–6 samples per patient; median 1) with &gt;1 monoclonal heavy and/or light chain bands on combined serum and urine immunofixation, and corresponding SFLC results. 6 samples were from 2 patients (1 and 5 samples each) known to have biclonal disease where each clone had a different light chain specificity. The remaining samples were from patients known to have a single monoclonal protein. Immunofixation on 10 (19%) samples did not show the original monoclonal protein isotype, and 42 (81%) did. 17 (33%) samples came from patients in complete remission (CR) or near-CR based on stringent conventional criteria. Based on a review of clinical and treatment history, 23 (42%) samples were classified as being from patients who had “active disease” (stable or progressive) and 29 were classified as being from patients with “inactive disease” (CR/near-CR or showing ongoing response to current therapy). SFKLR was normal in 20 (39%) samples. The table shows the relationship between SFKLR and the presence of the original paraprotein isotype, CR/near-CR, or disease activity. Subgroup Abnormal SFKLR Normal SFKLR P Original monoclonal protein 0.068 - Present 19/42 (45%) 23/42 (55%) - Absent 1/10 (10%) 9/10 (90%) Disease status 0.038 - CR/near-CR 3/17 (18%) 14/17 (82%) - Not in CR/near-CR 17/35 (49%) 18/35 (51%) Disease activity 0.10 - Inactive 14/29 (48%) 15/29 (52%) - Active 6/23 (26%) 17/23 (74%) Absence of the original monoclonal protein and CR/near-CR were significantly more likely to be associated with normal SFKLR. On the other hand, there was no significant relationship between SFKLR and disease activity. The level of monoclonal protein on serum protein electrophoresis did not correlate with SFKLR: 9 of 22 samples with monoclonal protein ≥0.2 g/dL had abnormal SFKLR compared with 11 of 30 samples with monoclonal protein &lt;0.2 g/dL (P=0.76). Of the 6 samples from patients with known biclonal disease, 3 had normal SFKLR (1 from 1 patient and 2 from the second patient) and 3 had abnormal SFKLR (all 3 from the second patient). On the single occasion when the disease was felt to be inactive, the SFKLR was abnormal, whereas it was normal on 3 of the 5 occasions when the disease was felt to be active. This suggests that SFLC is of limited value in the uncommon situation where biclonal disease is present with both κ and λ light chains. We conclude that in myeloma patients showing multiple monoclonal bands on immunofixation on or after therapy, the presence of a normal SFKLR suggests a significantly greater likelihood of CR/near-CR.

Abnormal Serum Free Light Chain Ratios Are Associated with Earlier Time to First Treatment and Poor Survival in Patients with Chronic Lymphocytic Leukaemia

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 3141-3141
Author(s):  
Guy Pratt ◽  
Graham Mead ◽  
Supratik Basu ◽  
Abe Jacobs ◽  
Roger Holder ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Lymphocytic Leukemia ◽  
Female Ratio ◽  
Cox Regression Analysis ◽  
Serum Free ◽  
Kaplan Meier ◽  
Mutational Status ◽  
Time To First Treatment

Abstract Introduction: Serum free light chains (sFLC) have prognostic significance in plasma cell disorders. In B-cell chronic lymphocytic leukemia (CLL), a small study found 8/18 (44%) of patients to have abnormal FLC ratios but no assessment of prognostic value was published. The aim of the present study was to determine whether abnormal serum FLC concentrations are indicative of a poor prognosis in CLL patients. Methods: Sera were analysed from 381 previously diagnosed CLL patients (Stage A 307; B 30; C 26; 18 missing; male: Female Ratio 1.6:1, mean age 71 (29–98)) with samples taken before their first treatment (303) or after treatment (78). The study was approved by the Birmingham Heart of England NHS Trust Review Board. Patients were described using the Binet staging system and measured for prognostic markers including CD38, Zap70, mutational status, β2M and FLC. Kaplan Meier survival curves and Cox proportional hazards regression (age, sex, CD38, Zap 70, mutational status, β2M and sFLC) were calculated using SPSS v14. Results: 147/381 (39%) patient sera had abnormal sFLC ratios. Kaplan Meier analysis of all deaths showed abnormal ratios were significantly associated with worse survival (n=350, p&lt;0.001). Analysis of deaths attributed to CLL (n=30) also indicated that an abnormal FLC ratio was predictive of shorter survival (p=0.001). However, for deaths not attributed to CLL (n=32), the FLC ratio was not significantly predictive of outcome (p=0.112). For Cox regression analysis (n=228) of deaths attributed to CLL only, three significant, independent, prognostic factors were identified: CD38 (p&lt;0.001), abnormal ratio (p&lt;0.001) and Stage (p=0.027). Analysis of the untreated patient population (n=303), using Kaplan Meier analysis of time to first treatment, found that an abnormal lambda ratio (p=0.04) but not an abnormal kappa ratio (p=0.443) predicted earlier treatment. For patients with an abnormal lambda ratio, the mean time to first treatment was 38 months earlier than those patients with a normal ratio. Cox regression analysis (n=171) of time to first treatment, found 4 significant, independent factors predicting earlier treatment: Zap70 (p&lt;0.001), Age (p&lt;0.001), abnormal sFLC ratio (p=0.001) and Stage (p=0.027). Conclusions: As shown in other monoclonal gammopathies, abnormal sFLC ratios were associated with poorer outcomes in patients with CLL. Furthermore, in an untreated population, patients with an abnormal lambda sFLC ratio required earlier treatment, indicating a pathological mechanism which is as yet unclear but which warrants further investigation.

Free radical-induced lipoperoxidation and severe head injury

1990 ◽  
Vol 16 (7) ◽  
pp. 444-447 ◽  
Author(s):  
M. Bochicchio ◽  
N. Latronico ◽  
D. G. Zani ◽  
M. Mariotti ◽  
L. Morandini ◽  
...  
Keyword(s):  
Free Radical ◽  
Head Injury ◽  
Severe Head Injury

scholarly journals Prognostic Significance of Serum Free Light Chains in Chronic Lymphocytic Leukemia

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Katerina Sarris ◽  
Dimitrios Maltezas ◽  
Efstathios Koulieris ◽  
Vassiliki Bartzis ◽  
Tatiana Tzenou ◽  
...  
Keyword(s):  
Prognostic Significance ◽  
Lymphocytic Leukemia ◽  
Light Chains ◽  
Free Light Chains ◽  
Prognostic Implication ◽  
Time To Treatment ◽  
Serum Free ◽  
Binet Stage ◽  
Serum Free Light Chains

Background. Serum free light chains (sFLC), the most commonly detected paraprotein in CLL, were recently proposed as useful tools for the prognostication of CLL patients.Objective. To investigate the prognostic implication of sFLC and the summated FLC-kappa plus FLC-lambda in a CLL patients’ series.Patients and Methods. We studied 143 CLL patients of which 18 were symptomatic and needed treatment, while 37 became symptomatic during follow-up. Seventy-two percent, 18%, and 10% were in Binet stage A, B and C, respectively. Median patients’ followup was 32 months (range 4–228).Results. Increased involved (restricted) sFLC (iFLC) was found in 42% of patients, while the summated FLC-kappa plus FLC-lambda was above 60 mg/dL in 14%. Increased sFLC values as well as those of summated FLC above 60 were related to shorter time to treatment (P=0.0005andP=0.000003, resp.) and overall survival (P=0.05andP=0.003, resp.). They also correlated withβ2-microglobulin (P=0.009andP=0.03, resp.), serum albumin (P=0.009for summated sFLC), hemoglobin (P<0.001), abnormal LDH (P=0.037andP=0.001, resp.), Binet stage (P<0.05) and with the presence of beta symptoms (P=0.004for summated sFLC).Conclusion. We confirmed the prognostic significance of sFLC in CLL regarding both time to treatment and survival and showed their relationship with other parameters.

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