Plasma monomeric calcitonin as a marker of disease activity in multiple myeloma patients with osteolysis.
Circulating monomeric human calcitonin (hCT-M), parathyroid hormone, osteocalcin, alkaline phosphatase, urinary hydroxyproline, corrected serum calcium and inorganic phosphate were measured in 49 multiple myeloma patients and 49 matched controls. In patients with Durie-Salmon stage III disease hCT-M levels (16.9 +/- 5.8 ng/l, mean +/- SD) were significantly higher than controls and stage I patients (P less than 0.01), and correlated directly with corrected serum calcium (r = 0.74; P less than 0.001). In the same subgroup 14 of 15 patients had plasma hCT-M concentrations higher than the mean + 2SD of the controls. The calcium infusion test induced an increase of hCT-M in normocalcemic patients which was significantly greater in patients with advanced disease than in either controls or stage I patients. These findings suggest that hCT-M may be a biochemical index of bone resorption and disease activity in myeloma patients with osteolysis. In fact, its plasma concentrations were elevated in a large proportion (93%) of patients with severe bone involvement, and correlated directly with serum calcium. Moreover, our findings suggest the presence of a calcitonin-dependent calcium homeostatic mechanism, that protects against hypercalcemia due to tumor osteolysis.
Monti
M
M
IV Department of Medicine, Geriatric Institute Pio Albergo Trivulzio, Milano, Italy.
Scazzoso
A
A
Bevilacqua
M
M
Santi
I
I
D'Aprile
E
E
Saligari
A
A
Norbiato
G
G
Cunietti
E
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D002116:Calcitonin / Q000097:blood*; D002118:Calcium / Q000097:blood; D005260:Female; D006801:Humans; D006909:Hydroxyproline / Q000652:urine; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood* / Q000150:complications; D015675:Osteocalcin / Q000097:blood; D010014:Osteolysis / Q000097:blood* / Q000209:etiology
D014408:Biomarkers, Tumor; D015675:Osteocalcin; D002116:Calcitonin; D000469:Alkaline Phosphatase; D006909:Hydroxyproline; D002118:Calcium