Acute phase proteins and prognosis in multiple myeloma

• Published in: British journal of haematology Vol. 83; no. 4; p. 595
• Main Authors: Merlini, G, Perfetti, V, Gobbi, P G, Quaglini, S, Franciotta, D M, Marinone, G, Ascari, E
• Format: Journal Article
• Language: English
• Published: England 01.04.1993
• Subjects: Acute-Phase Proteins - analysis; Adult; Aged; Aged, 80 and over; alpha 1-Antitrypsin - analysis; beta 2-Microglobulin - analysis; Biomarkers - analysis; C-Reactive Protein - analysis; Female; Humans; Male; Middle Aged; Multiple Myeloma - blood; Multiple Myeloma - mortality; Prognosis
• ISSN: 0007-1048
• DOI: 10.1111/j.1365-2141.1993.tb04696.x

Serum IL-6 levels have been shown to correlate with disease severity and prognosis in patients with plasma cell dyscrasias. Among its pleiotropic actions, IL-6 is also the major regulator of the acute phase response in humans. The possible impact on survival of the major serum acute phase proteins (s.APP) [C-reactive protein (s.CRP), alpha-1-antitrypsin (s.AAT), haptoglobin, acid alpha-1-glycoprotein and alpha-2-macroglobulin (used as control)] was assessed on a population of 103 consecutive, previously untreated myeloma patients. Univariate analysis showed that among the acute phase proteins only s.AAT (P = 0.015) and s.CRP (P = 0.027) were significantly correlated with survival. The multivariate Cox proportional hazard model applied to s.APP and other common parameters showed that s.beta-2-microglobulin (s.b2M), s.calcium, s.creatinine, BM plasma cell percentage, age and s.AAT correlated significantly with survival. Combining s.b2M and s.AAT allowed stratification of myeloma patients: those with low levels of s.b2M (< or = 3 mg/l) and of s.AAT (< or = 3 g/l) presented an excellent prognosis (median survival exceeding 10 years) while those presenting higher values of the two parameters presented a median survival of 2.5 years (P = 0.002).