High-density lipoprotein (HDL) has an impact on myeloma outcome: Lower HDL associates with worse progression-free survival.

Abstract

Multiple myeloma (MM) staging is based on beta‑2 MG, albumin, LDH levels, and the presence of chromosomal abnormalities. We aimed to evaluate the impact of high-density lipoprotein (HDL) on myeloma outcomes. This study included 148individuals; 68patients diagnosed with MM and 80age, sex, comorbidity-matched controls. The relationship between HDL and myeloma stage and the association between HDL and progression-free survival (PFS) were analyzed. Sixty-five percent of patients were male in each group. Mean HDL level was higher in the control group than myeloma group (52.6 ± 15.02 mg/dl versus 33.79 ± 12.71) (p < 0.001). According to ISS, 39patients (57%) had advanced stage (ISS-III) disease. To assess the optimal cut-point for HDL that makes adifference in PFS, the X‑tile software program was used and in line with the created plots, the myeloma cohort was divided into two groups as HDL < 28 and ≥ 28 mg/dl. Twenty-two patients (32.4%) were in HDL < 28 group. According to the ISS, HDL < 28 group had more advanced disease than the HDL ≥ 28 group (p = 0.008). Twenty-nine patients (42.6%) progressed or died during the follow-up and 15of these were in the HDL < 28 group. Time to progression was shorter in patients who were in the HDL < 28 group (median, 22versus 40months, p = 0.03). There was no statistically significant difference between these groups in terms of overall survival (p = 0.708). Myeloma patients have lower HDL than controls and HDL < 28 mg/dl associates with advanced-stage disease and shorter PFS. Therefore, HDL can be asurrogate prognostic marker in myeloma.