Abstract
ABSTRACTObjective: Frequent loss of expression of platelet factor 4 (PF4) in multiple myeloma (MM) was revealed in several previous researches. The predictive analysis of serum PF4 level in newly diagnosed MM has not been well elucidated. This study is to assess if serum PF4 could be a prognostic factor in predicting treatment response and survival of MM treated with thalidomide and VAD regimens.Methods: Sera of 122 MM were gained pre- and post-treatment of chemotherapy and oral thalidomide. Serological PF4 measurements were performed by ELISA. Kaplan–Meier method was employed for survival analysis. Log rank test was used significance analysis. Multivariate analysis of overall survival used Cox-regression.Results: Our data showed that the median serum PF4 concentration was negatively associated with MM response and a significant correlation between serum PF4 level and unfavorable clinical features (β2-microglobulin, ISS stage, del17p and creatinine). MM with lower serum PF4 concentration at diagnosis were prone to gain complete remission and very good partial remission after two courses of chemotherapy. Besides del17p, β2-microglobulin, treatment response, the low serum PF4 concentration was an independent variable associated with a poor overall survival by univariate analysis and multivariate analysis.Conclusions: We speculate serum PF4 is a promising response and prognostic factor in newly diagnosed MM treated with thalidomide and VAD regimens.
Highlights
Multiple myeloma (MM) is a clonal B cell disorder characterized by skeletal destruction, renal failure, anemia, susceptibility to recurrent infections and hypercalcemia [1]
Our data showed that the median platelet factor 4 (PF4) serum concentration was negatively associated with MM response
Our present results showed a significant correlation between serum PF4 level and unfavorable clinical features
Summary
Multiple myeloma (MM) is a clonal B cell disorder characterized by skeletal destruction, renal failure, anemia, susceptibility to recurrent infections and hypercalcemia [1]. MM is common in elderly population [2]. With the aging of the population, the incidence of MM is increasing year by year and MM poses a great threat to people health. The exchange of MM cells with bone marrow microenvironment plays a pivotal role, especially angiogenesis. The tumor angiogenesis of MM are via autocrine or paracrine of angiogenic factors by bone marrow stromal cells and myeloma cells. Angiogenesis is closely related to progression and prognosis of myeloma [4]. Based on this knowledge, prototypic drugs thalidomide and lenalidomide have been approved for MM by targeting both MM cells and angiogenesis [5]
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