IMMUNOREACTIVE INTERLEUKIN-6 AND ACUTE-PHASE PROTEINS AS PROGNOSTIC FACTORS IN MULTIPLE-MYELOMA
IMMUNOREACTIVE INTERLEUKIN-6 AND ACUTE-PHASE PROTEINS AS PROGNOSTIC FACTORS IN MULTIPLE-MYELOMA
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DOI：
10.1182/blood.v85.3.765.bloodjournal853765
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发表时间：
1995-02-01
期刊：
影响因子：
20.3
通讯作者：
LAHTINEN, R
中科院分区：
文献类型：
--
作者：
PELLINIEMI, TT;IRJALA, K;LAHTINEN, R
High serum level of bioactive interleukin-6 (IL-6) is regarded as a predictor of poor prognosis in multiple myeloma (MM).另一方面，报道的免疫反应性 IL-6 水平变化很大，并且免疫反应性 IL-6 在 MM 中的预后价值尚不清楚。我们分析了 210 名新诊断 MM 患者随后接受间歇性美法仑和泼尼松治疗后血清免疫反应性 IL-6 的预后意义（通过灵敏的免疫吸附测定进行测量）。将急性期蛋白 C 反应蛋白 (CRP)、α 1-抗胰蛋白酶 (α 1AT) 和酸性 α 1-糖蛋白（orosumucoid；OM）的血清水平作为 IL-6 的替代物进行评估。 Serum IL-6, CRP, alpha 1AT, and OM levels were raised in 42%, 40%, 41%, and 24% of the patients, respectively.患者的临床分期与诊断时的血清 IL-6 (P = .006)、α 1AT (P = .001) 和 OM (P = .004) 水平之间存在显着相关性。 3 年时，52% 的患者存活。单变量逻辑回归分析显示，高水平的 IL-6 (P = .002)、CRP (P = .02)、α 1AT (P < .001)、OM (P = .007)、β 2-微球蛋白 (β 2M；P < .001) 和胸苷激酶 (P < .05) 均与 8 年死亡率相关。 In multivariate regression analysis, beta 2M (P < .0001) and alpha 1AT (P = .01) had independent prognostic significance. β2M 和 α1AT 或 IL-6 水平较高的患者在诊断后 3 年内死亡的风险非常高（这些组中分别有 16% 和 21% 的患者存活）。当根据临床分期对患者进行分层时，血清IL-6和α1AT的预后意义在II期患者中尤其明显。当根据血清 IL-6 水平正常或升高将患者分为两组时，IL-6 水平高的患者发生更频繁的溶骨性骨病变 (P = .03)，从而导致疾病更具侵袭性。 We conclude that serum immunoreactive IL-6 is a significant prognostic marker in MM. (C) 1995 年，美国血液学会。
High serum level of bioactive interleukin-6 (IL-6) is regarded as a predictor of poor prognosis in multiple myeloma (MM). On the other hand, the reported levels of immunoreactive IL-6 have been highly variable, and the prognostic value of immunoreactive IL-6 in MM is not clear. We have analyzed the prognostic significance of serum immunoreactive IL-6, as measured by a sensitive immunosorbent assay, in 210 patients with newly diagnosed MM subsequently treated with intermittent melphalan and prednisone. The serum levels of acute phase proteins C-reactive protein (CRP), alpha 1-antitrypsin (alpha 1AT), and acid alpha 1-glycoprotein (orosomucoid; OM) were evaluated as surrogates for IL-6. Serum IL-6, CRP, alpha 1AT, and OM levels were raised in 42%, 40%, 41%, and 24% of the patients, respectively. There was a significant correlation between the clinical stage of the patients and serum IL-6 (P = .006), alpha 1AT (P = .001), and OM (P = .004) levels at diagnosis. At 3 years, 52% of the patients were alive. Univariate logistic regression analysis showed that high levels of IL-6 (P = .002), CRP (P = .02), alpha 1AT (P < .001), OM (P = .007), beta 2-microglobulin (beta 2M; P < .001), and thymidine kinase (P < .05) were all associated with 8-year mortality. In multivariate regression analysis, beta 2M (P < .0001) and alpha 1AT (P = .01) had independent prognostic significance. The patients with high levels of both beta 2M and alpha 1AT or IL-6 were at very high risk of dying within 3 years from diagnosis (16% and 21% of the patients in these groups were alive, respectively). When the patients were stratified according to the clinical stage, the prognostic significance of serum IL-6 and alpha 1AT was especially evident in stage II patients. When the patients were divided into two groups according to normal or raised serum IL-6 levels, the patients with high IL-6 levels had more frequent osteolytic bone lesions (P = .03) end a more aggressive disease. We conclude that serum immunoreactive IL-6 is a significant prognostic marker in MM. (C) 1995 by The American Society of Hematology.