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Serum thymidine kinase as a prognostic indicator for patients with multiple myeloma: results from the MRC (UK) V Trial
Author(s) -
Brown R. D.,
Joshua D. E.,
Nelson M.,
Gibson J.,
Dunn J.,
MacLennan I. C. M.
Publication year - 1993
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1993.tb03058.x
Subject(s) - medicine , melphalan , multiple myeloma , oncology , chemotherapy , cyclophosphamide , gastroenterology , monoclonal gammopathy of undetermined significance , immunology , monoclonal , antibody , monoclonal antibody
Summary. The significance of serum thymidine kinase (STK) as a prognostic indicator for patients with myeloma has been evaluated by determining the pre‐treatment level of STK in a retrospective study of 547 patients from the Medical Research Council (MRC) V Myeloma Trial. Overall, STK was a highly significant prognostic factor (Chi 2 = 7.91; P = 0.005). At the time of censor, 23.4% of patients with a presentation STK of < 6 U/l but only 7.9% of the patients with an STK of > 11 U/l were still alive. STK proved to be a highly significant prognostic indicator for the 270 melphalan‐treated patients (Chi 2 = 12·37; P , = 0.0004) but had no prognostic significance for the 277 ABCM (adriamycin, BCNU, cyclophosphamide and melphalan) treated patients (Chi 2 = 0.29; P = 0.59). When the STK data was stratified for serum B‐2‐microglobulin (SB 2 M) it was demonstrated that STK was independent of SB 2 M and provided additional prognostic information for patients who were treated with melphalan. Thus patients with both a low STK and SB 2 M had the best prognosis (median survival 1677 d) and those patients with a high STK and SB 2 M had the worst prognosis (median survival 519 d). STK is a good prognostic marker for patients treated with melphalan but the prognostic significance of STK may disappear with the introduction of new chemotherapy regimens.