Prognostic significance of serum cystatin C in multiple myeloma

Abstract

Objective To investigate the prognostic significance of serum cystatin C in multiple myeloma (MM).Methods 160 cases of newly diagnosed MM patients with average age of 61.38 years old.Determine the levels of serum cystatin C,serum creatinine,β 2-microglobulin,lactate dehydrogenase and hemoglobin before the treatment; median follow-up of 38 months,observe the relationship between serum cystatin C with overall survival (OS) and event-free survival (EFS).Results Median serum cystatin C level in 160 MM patients was higher than that in the 80 healthy controls [(0.96 ± 0.32) mg/L vs (0.71 ± 0.16) mg/L,P ＜ 0.000].All the patients in ISS stage were divided into 3 stages.Median serum cystatin C levels significantly increased in higher ISS stages [stage Ⅰ (0.70±0.13) mg/L,stage Ⅱ (0.87±0.16) mg/L,stage Ⅲ(1.23±0.33) mg/L (P ＜ 0.05)],serum cystatin C level was positively correlated with levels of serum creatinine (r =0.669,P ＜ 0.000),β2-microglobulin (r =0.672,P ＜ 0.000).lactate dehydrogenase (r =0.521,P ＜ 0.000),and negatively correlated with hemoglobin levels (r =-0.436,P ＜ 0.000).Using ROC analysis,patients with serum cystatin C levels ＞ 0.95 mg/L had significantly shorter EFS and OS patients with serum cystatin C levels ≤0.95 mg/L (median EFS:30 vs 57 months,P ＜ 0.05; median OS:43 vs 68 months,P ＜ 0.05).Conclusion Serum cystain C is not only a sensitive marker of kidney damage,but also reflects tumor burden and delivers prognostic information in MM. Key words: Serum cystatin C; Multiple myeloma; Prognostic marker