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Acute phase proteins and prognosis in multiple myeloma
Author(s) -
Merlini Giampaolo,
Perfetti Vittorio,
Gobbi Paolo G.,
Quaglini Silvana,
Franciotta Diego M.,
Mari Gabriella,
Ascari Edoardo
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.tb04696.x
Subject(s) - multiple myeloma , medicine , phase (matter) , myeloma protein , acute phase protein , intensive care medicine , cancer research , oncology , chemistry , organic chemistry , inflammation
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‐anti‐trypsin (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.β‐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 (3 mg/l) and of s.AAT ( 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).