Bone marrow plasma level of decorin may be associated with improved treatment outcomes in a subset of multiple myeloma patients

Abstract

Decorin is a small leucine-rich proteoglycan rich in extracellular matrix with potential antitumor activity. However, the role of decorin in hematological malignancies remains unclear, especially in the case of multiple myeloma (MM), a bone marrow (BM) stroma-dependent plasma cell neoplasm. We measured decorin levels in BM plasma samples from 270 patients with newly diagnosed MM (NDMM) using enzyme-linked immunosorbent assays. Patients were divided into high decorin (H-DCN, > 18.99ng/mL) and low decorin (L-DCN <9.76ng/mL) groups. Patients in the H-DCN group had more advanced-stage disease, including more osteolysis terms of higher levels of C-terminal telopeptides of type I collagen (0.69±0.55 vs. 0.49±0.36ng/mL; P=0.028), than those in the L-DCN group. Decorin levels correlated positively with hepatocyte growth factor (HGF) levels in BM plasma samples from NDMM patients (Pearson correlation coefficient, 0.226; P<0.001). Patients with low HGF (<0.79ng/mL) but high decorin levels (≥12.95ng/mL) had a higher treatment response rate (90.5% vs. 54.5%, respectively; P=0.015) and improved overall survival (not reached vs. 53 months; P=0.0148) than those with lower decorin levels (<12.95ng/mL). Multivariate analysis confirmed that a high decorin level was an independent predictive factor for treatment response and survival in patients with low HGF levels. Our findings suggest that decorin may exert protective effects in this subset of MM patients.