title: Increased serum neopterin concentration as indicator of disease severity and poor survival in multiple myeloma.
abstract: In this study we investigated serum neopterin levels in 73 multiple myeloma (MM) patients (63 determinations at diagnosis, 58 in remission, and 35 at relapse), in 56 monoclonal gammopathies of undetermined significance (MGUS), and in 70 normal controls. Median neopterin level was 5.3 nmol/l in normal controls, 6.8 nmol/l in MGUS, and 10.7 nmol/l in MM patients. In comparison to healthy subjects, significantly higher levels were observed in MM patients (p less than 0.0001). A statistical difference was observed between MGUS and MM patients at diagnosis (p less than 0.007). Compared to diagnosis, a further increase was noticed during relapse, suggesting a correlation between neopterin and disease activity. The prognostic significance of raised neopterin levels was confirmed by a survival analysis. Median survival for patients with high values was 20 months, whereas it was 63.9 months for those with low values (log-rank test p less than 0.003). Serum neopterin concentrations also correlated to beta 2 microglobulin levels and the percentage of CD38+ circulating lymphocytes, indicating a link between neopterin and other myeloma prognostic factors.
authors.affiliation: Dipartimento di Medicina e Oncologia, Università di Milano, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Boccadoro
authors.forename: S
authors.initials: S
authors.lastname: Battaglio
authors.forename: P
authors.initials: P
authors.lastname: Omedè
authors.forename: A P
authors.initials: AP
authors.lastname: Palumbo
authors.forename: A
authors.initials: A
authors.lastname: Fusaro
authors.forename: R
authors.initials: R
authors.lastname: Frieri
authors.forename: G
authors.initials: G
authors.lastname: Gallone
authors.forename: R
authors.initials: R
authors.lastname: Polloni
authors.forename: R
authors.initials: R
authors.lastname: Mosso
authors.forename: P G
authors.initials: PG
authors.lastname: De Filippi
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D001708:Biopterins / Q000031:analogs & derivatives* / Q000097:blood; D001853:Bone Marrow / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D008214:Lymphocytes / Q000276:immunology; D009101:Multiple Myeloma / Q000097:blood* / Q000473:pathology / Q000503:physiopathology; D019798:Neopterin; D010265:Paraproteinemias / Q000097:blood; D010641:Phenotype; D011379:Prognosis; D012016:Reference Values; D001613:beta 2-Microglobulin / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; D001613:beta 2-Microglobulin; D001708:Biopterins; D019798:Neopterin