Impact of Absolute Lymphocyte Count on Kappa Lambda Ratio in Autologous Transplantation for IgG Myeloma

Abstract

Background: Multiple myeloma (MM) is a neoplastic haematological disorder characterised by clonal proliferation of malignant plasma cells. The disease becomes fatal if not treated effectively. Autologous Peripheral Blood Stem Cell Transplantation (PBSCT) is an effective therapeutic intervention at present. Although Kappa Lambda ratio (KL ratio) assessment helps the diagnosis and treatment monitoring, finding of an inexpensive Absolute Lymphocyte Count (ALC) remains valid in screening treatment outcomes. Objective: To establish correlation between KL ratio and Absolute Lymphocyte Count (ALC) through statistical modeling of patients with MM (IgG Kappa type) in Pre and Post PBSCT at Apeksha Hospital, Maharagama Methods: A cross-sectional study of 68 MM (IgG Kappa type) patients under 70 years was carried out. Absolute Lymphocyte Count (ALC) and KL ratios were obtained from pre-transplant and post-transplant phases. Linear regression analysis was performed to develop reliable equations to predict KL ratios from ALC for each time period using SPSS version 25.0. Results: Different reliable formulas for KL ratios were derived for the time periods of pre- and post-transplant stages. Among them, the two months after transplant stage provided a strong reliable equation; KL ratio_2 Mon Aft = 1.086 X (ALC_2 Mon Aft) – 1.056 [R2 = 0.797; p (ALC_2 MonAft) <0.001; p (KL_2 MonAft) <0.001. Conclusions: The present findings indicate that the KL ratio from the simple inexpensive ALC could potentially be predicted using regression equations at the two month after transpalntation. The results suggest that a simple FBC parameter could serve as a potential screening tool in the absence of the KL ratio. These early findings are promising and, should be validated by an expanded sample size before bringing them into practice.