Biomarkers of minimal residual disease in rituximab-treated patients with mixed cryoglobulinemia

Umberto Basile, Francesca Gulli, Cecilia Napodano, Krizia Pocino, Valerio Basile, Ramona Marrapodi, Stefania Colantuono, Laura Todi, Mariapaola Marino, Gian Ludovico Rapaccini, Marcella Visentini

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Hepatitis C virus (HCV) represents the major risk factor for mixed cryoglobulinemia (MC), a small-vessel vasculitis that may evolve into an overt B-cell non-Hodgkin's lymphoma. Here, we aimed to identify a biomarker signature for the early diagnosis of minimal residual disease (MRD). We assessed free light chains (FLCs), IgMk and IgMλ heavy-light chain (HLC) pairs, and vascular endothelial growth factor (VEGF) in sera from 34 patients with MC vasculitis (32 HCV- and 2 HBV-related), treated with low-dose rituximab (RTX). FLCs and IgM HLCs were measured by turbidimetric assay; VEGF by an enzyme-linked immunosorbent assay. After RTX, the positive (complete + partial) clinical and laboratory responses were of 85.29% and 50% respectively; in contrast, the mean levels of FLCs, IgM HLCs and VEGF were substantially unaffected in most patients and still above the normal range. In those achieving a reduction of FLCs and IgM k and λ chains values within the range of normality, we found that post-treatment free λ chains and IgM k values correlated with clinical and laboratory response. Our results suggest that high levels of FLCs, IgM HLCs and VEGF could represent the signature of "dormant" B cell clones' activity that could be very useful to identify MRD indicative of possible relapse or worsening outcome.
Original languageEnglish
Pages (from-to)N/A-N/A
JournalBiotechnology and Applied Biochemistry
Volume2020
DOIs
Publication statusPublished - 2020

Keywords

  • HCV
  • IgM heavy/light chains
  • biomarkers
  • free light chains
  • minimal residual disease
  • mixed cryoglobulinemia
  • rituximab
  • vascular endothelial growth factor

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