Browsing by Author "Gbotosho, Olabisi Abosede"

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    Evaluation of serum free light chains as markers of disease severity in patients with chronic lymphocytic leukaemia in southwestern Nigeria.
    (Department Of Haematology and Immumology, Faculty Of Basic Medical Sciences, College of Health Sciences, Obafemi Awolowo University, 2022) Gbotosho, Olabisi Abosede
    The aim of this study is to determine the haematological parameters, disease severity, serum lactate dehydrogenase, serum β2 microglobulin, serum creatinine and serum free light chains kappa and lambda of newly diagnosed CLL patients; and assess the relationship between the pattern of free light chains and the measured parameters, with the view to improve treatment of chronic lymphocytic leukemia patients. Thirty-three newly diagnosed CLL patients were enrolled into the study using convenience sampling method. Patients with other chronic illnesses or in disease transformation were excluded. Ethical approval was obtained from the National Health Research Ethics Committee of Nigeria. Data on socio-demographic characteristics, general physical and systemic examination was also collected for each eligible patient, after informed consent was obtained. Clinical disease severity score was determined using the Binet staging system. Ten milliliters of venous blood were collected; 5ml were anticoagulated using EDTA to obtain haematological parameters from an haemo-autoanalyzer; and for making peripheral blood film using standard operating procedures. The remaining 5ml of blood was dispensed into a plain bottle to obtain serum using standard operating procedures. The sera collected were stored at -200C and batch tested for serum free light chains, kappa and lambda, from which the kappa/lambda ratio was calculated, β2-microglobulin, lactate dehydrogenase (LDH) and creatinine. Numerical values were reported as frequency, percentage, median, interquartile range, minimum and maximum values. Bivariate analysis was used for continuous variables while chi-square test was used for non-continuous variables data. A p-value ≤ 0.05 or 95% CI (CI=95%) was defined as statistical significance. The results showed that age range of the studied population was between 44 and 71, with a median age of 56years (51.5-64.0). There were 17 (51.5%) males and 16 (48.5%) females. The majority (45.5%) were traders, whilst 30.3% were retirees, 18.2% were civil servants, and 6.1% were artisans. At presentation, 18.2% were in Binet stage A, 6.1% in Binet stage B, while 75.8% were in Binet stage C. The median haemoglobin value was 10.0g/dl (8.05-11.5). The median packed cell volume was 31.0% (25.0-34.0), the median platelet count was 89,000x109/μl (73,600-211,300), the median white cell count was 85,740 x109/μl (64,200-134,600), the median absolute lymphocyte count was 76,200x109/μl (59,685-127,300), the median absolute neutrophil count was 4,960 x109/μl (3,323-8,596), the median absolute eosinophil count was 140x109/μl (100-260), the median basophil count was 300x109/μl (180-660) and the median monocyte count was 0.00x109/μl (0.0-350). Serum kappa median value was 982mg/l (770-1215) and lambda median value was 440mg/l (351-496). The median value of the calculated kappa-lambda ratio (k/λ) was 2.33 (1.95-2.56).The β2-microglobulin median value was 6.38μg/ml (5.78-6.91), the LDH median value was 207μg/l (176-981) and creatinine median value was 1.17mg/dl (0.88-1.62). The FLC pattern showed that 87.9% of the patients had kappa light chain clonality, 12.1% had polyclonality, while none had lambda light chain clonality. There is a significant direct relationship between FLC-r and disease severity (f=0.833, p<0.001), β2-microglobulin (r =0.38, p=0.030) and a significant inverse relationship between FLC-r and haemoglobin (r= -0.52, p=0.002) and platelet (r= -0.44, p=0.011). The relationships between FLC-r and LDH, creatinine, white cell count and differentials were weak and insignificant (p>0.05). The study concluded that free light chain ratio has a surrogate biomarker relationship with disease severity and may be a useful tool for the assessment of disease prognosis in CLL in nigerian patients.