title: The clinical and prognostic significance of erythrocyte sedimentation rate (ESR), serum interleukin-6 (IL-6) and acute phase protein levels in multiple myeloma.
abstract: Interleukin-6 (IL-6) and acute phase proteins are commonly increased in patients with multiple myeloma. Several of these acute phase proteins are believed to predict prognosis and influence survival. We measured interleukin-6 (IL-6), C-reactive protein (CRP), alpha-1-antitrypsin (a1AT), acid alpha-1-glycoprotein (a1AG), haptoglobin (HAP), transferrin (TRF), hemoglobin (Hb), beta-2-microglobulin (beta2M) and erythrocyte sedimentation rate (ESR) in 42 newly diagnosed multiple myeloma patients and 25 normal controls. At the time of blood collection, nine patients were at stage I of disease, 14 at stage II, and 19 at stage III according to the Durie and Salmon myeloma staging system. Mean +/- SD values of IL-6, CRP, a1AT, a1AG, HAP, beta2M, and ESR were significantly higher and Hb significantly lower than those found in the controls. Univariate analysis, using the log-rank test, showed that among the acute phase proteins, serum CRP (P < 0.002), a1AT (P < 0.008) and ESR (P < 0.008) were significantly correlated with survival. However, when a multivariate Cox proportional hazard model was performed, ESR, CRP, a1AT, a1AG and beta2M were identified as independent prognostic factors, while the others were not. We conclude that ESR, a simple and easily performed marker, was found to be an independent prognostic factor for survival in patients with multiple myeloma.
authors.affiliation: Department of Haematology, University Hospital of Heraklion, Crete, Greece.
authors.forename: M G
authors.initials: MG
authors.lastname: Alexandrakis
authors.forename: F H
authors.initials: FH
authors.lastname: Passam
authors.forename: E S
authors.initials: ES
authors.lastname: Ganotakis
authors.forename: K
authors.initials: K
authors.lastname: Sfiridaki
authors.forename: I
authors.initials: I
authors.lastname: Xilouri
authors.forename: K
authors.initials: K
authors.lastname: Perisinakis
authors.forename: D S
authors.initials: DS
authors.lastname: Kyriakou
mesh_terms: D000209:Acute-Phase Proteins / Q000032:analysis*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001799:Blood Sedimentation; D016022:Case-Control Studies; D005260:Female; D006242:Haptoglobins / Q000032:analysis; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D009961:Orosomucoid / Q000032:analysis; D011379:Prognosis; D016019:Survival Analysis; D014168:Transferrin / Q000032:analysis; D000515:alpha 1-Antitrypsin / Q000032:analysis
chemical_list: D000209:Acute-Phase Proteins; D006242:Haptoglobins; D015850:Interleukin-6; D009961:Orosomucoid; D014168:Transferrin; D000515:alpha 1-Antitrypsin