title: Urinary N-telopeptide levels in multiple myeloma patients, correlation with Tc-99m-sestaMIBI scintigraphy and other biochemical markers of disease activity.
abstract: Urinary cross-linked N-telopeptide of type I collagen (NTx) has been reported to be a sensitive and specific marker of bone resorption in multiple myeloma (MM). In this study, we measured the levels of NTx in 30 newly diagnosed MM patients and 25 controls. We examined its association with the overall score of skeletal involvement measured by Tc-99m-MIBI scintigraphy and other biochemical markers of bone disease (tumour necrosis factor a (TNF-a), serum calcium and creatinine). We further studied the correlation of NTx with the stage of disease (according to Durie-Salmon criteria) and bone marrow infiltration by plasma cells. High levels of NTx, bone marrow infiltration, TNF-alpha, calcium and creatinine were noted at advanced stages of disease (p < 0.05). NTx and TNF-a were found at significantly higher concentrations in patients with a high overall score (3 and 4) in Tc-99m-sestaMIBI in comparison to a low score (0, 1 and 2; p < 0.05). Positive correlations were found between NTx and TNF-a, as well as between bone infiltration and TNF-a or calcium. In conclusion, NTx is a useful marker for the monitoring of bone resorption in MM and correlates with imaging findings on Tc-99m-sestaMIBI and other biochemical markers of disease activity.
authors.affiliation: Department of Hematology, University Hospital of Crete, Greece.
authors.forename: M G
authors.initials: MG
authors.lastname: Alexandrakis
authors.forename: D S
authors.initials: DS
authors.lastname: Kyriakou
authors.forename: F H
authors.initials: FH
authors.lastname: Passam
authors.forename: N
authors.initials: N
authors.lastname: Malliaraki
authors.forename: I G
authors.initials: IG
authors.lastname: Vlachonikolis
authors.forename: N
authors.initials: N
authors.lastname: Karkavitsas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001842:Bone and Bones / Q000528:radiation effects; D002118:Calcium / Q000097:blood; D003094:Collagen / Q000097:blood* / Q000652:urine*; D024042:Collagen Type I; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000378:metabolism; D007074:Immunoglobulin G / Q000378:metabolism; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood* / Q000175:diagnosis* / Q000652:urine*; D010455:Peptides / Q000097:blood* / Q000652:urine*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012886:Skull / Q000000981:diagnostic imaging; D017256:Technetium Tc 99m Sestamibi / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D024042:Collagen Type I; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D010455:Peptides; D019275:Radiopharmaceuticals; C052929:collagen type I trimeric cross-linked peptide; D003094:Collagen; D017256:Technetium Tc 99m Sestamibi; D003404:Creatinine; D002118:Calcium