Abstract
Background: Proliferating cell nuclear antigen (PCNA), a cofactor for δDNA-dependent DNA polymerase, is an indicator of the proliferative state of the cell. Il-6 and sIl-6R are known to be growth factors for human myeloma cells. The study was aimed at testing the correlations between cytomorphology and PCNA expression in myeloma plasma cells, as well as serum Il-6 and sIl-6R concentrations in 36 patients in an advanced stage of the disease. Methods: PCNA was determined and either lambda or kappa light chain double staining of multiple myeloma (MM) plasma cells was performed. Il-6 and sIl-6R serum concentrations were assessed with the ELISA method. Results: PCNA-positive cells ranged from 5% to 100%; higher PCNA expression was observed in patients with immature plasma cells (mean=28.8%, S.D.=3.2), the highest in MM with plasmablasts in bone marrow (mean=57.2%, S.D.=28.0). Serum Il-6 and sIl-6R levels were higher in the plasmablastic type of MM than in mature ones (P=0.02 and P=0.01, respectively). Elevated PCNA expression and increased serum Il-6 and sIl-6R levels were present in patients with hyperviscosity coma as well as in patients with renal failure. Conclusions: PCNA expression in myeloma plasma cells indicates the myeloma's proliferative activity and correlates positively with serum Il-6 and sIl-6R concentrations, especially in advanced stages of the disease.
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