title: Serum syndecan-1, basic fibroblast growth factor and osteoprotegerin in myeloma patients at diagnosis and during the course of the disease.
abstract: Neovascularisation and bone resorption are related to myeloma disease activity.
  
  
  OBJECTIVE
  To investigate the possible prognostic importance of serum syndecan-1, basic fibroblast growth factor (bFGF) and osteoprotegerin (OPG) levels, the relationship between them, with parameters of disease activity and the effect of treatment on their levels.
  
  
  METHODS
  Twenty-seven patients were studied from diagnosis and an additional five from remission, for a median follow-up of 40 months. Twenty-three patients received chemotherapy plus bisphosphonates and nine only bisphosphonates. Sera from 11 healthy individuals (HI) were used as controls. Cytokines were determined by commercially available enzyme-linked immunosorbent assays (ELISA) kits.
  
  
  RESULTS
  In HI, median syndecan-1 was 40 ng/mL (28-75), bFGF 8 pg/mL (7-30), OPG 35 pg/mL (4-100). Pretreatment median serum syndecan-1 was 177.5 ng/mL (34-3500), bFGF 11.5 pg/mL (8-65) and OPG 100 pg/mL (4-1000). Pretreatment syndecan-1, bFGF and OPG serum levels were increased in patients compared with HI (P = 0.001, 0.03 and 0.01, respectively). Syndecan-1 and bFGF levels were correlated with stage (P = 0.004 and 0.03, respectively). Both syndecan-1 and OPG levels were correlated with beta2M (P = 0.04 and 0.01, respectively). Patients with elevated syndecan-1 and bFGF serum levels had shorter survival than patients with normal levels (P = 0.01 and 0.05, respectively). After chemotherapy syndecan-1 and OPG levels were found to be decreased in responders and syndecan-1 level was reduced in patients receiving bisphosphonates alone.
  
  
  CONCLUSIONS
  Pretreatment syndecan-1, bFGF and OPG levels were found to be increased at diagnosis. Syndecan-1 and OPG fluctuated according to MM activity. Elevated serum syndecan-1 and bFGF levels predicted short survival.
authors.affiliation: Hematology Section and Research Laboratory, First Department of Internal Medicine, National and Kapodistrian University of Athens, School of Medicine, Laikon General Hospital, Athens, Greece.
authors.forename: Maria-Christina
authors.initials: MC
authors.lastname: Kyrtsonis
authors.forename: Theodoros P
authors.initials: TP
authors.lastname: Vassilakopoulos
authors.forename: Marina P
authors.initials: MP
authors.lastname: Siakantaris
authors.forename: Styliani I
authors.initials: SI
authors.lastname: Kokoris
authors.forename: Despina A
authors.initials: DA
authors.lastname: Gribabis
authors.forename: Maria N
authors.initials: MN
authors.lastname: Dimopoulou
authors.forename: Maria K
authors.initials: MK
authors.lastname: Angelopoulou
authors.forename: Gerassimos A
authors.initials: GA
authors.lastname: Pangalis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood*; D001862:Bone Resorption / Q000097:blood / Q000209:etiology; D003520:Cyclophosphamide / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D004164:Diphosphonates / Q000627:therapeutic use; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D016222:Fibroblast Growth Factor 2 / Q000097:blood*; D005500:Follow-Up Studies; D006023:Glycoproteins / Q000097:blood*; D006801:Humans; D015993:Life Tables; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D008562:Membrane Glycoproteins / Q000097:blood*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D009363:Neoplasm Proteins / Q000097:blood*; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic / Q000097:blood / Q000209:etiology; D053244:Osteoprotegerin; D000077268:Pamidronate; D011241:Prednisone / Q000008:administration & dosage; D011379:Prognosis; D011509:Proteoglycans / Q000097:blood*; D018160:Receptors, Cytoplasmic and Nuclear / Q000097:blood*; D018124:Receptors, Tumor Necrosis Factor; D016019:Survival Analysis; D053668:Syndecan-1; D053667:Syndecans; D014750:Vincristine / Q000008:administration & dosage; D001613:beta 2-Microglobulin / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; D004164:Diphosphonates; D006023:Glycoproteins; D008562:Membrane Glycoproteins; D009363:Neoplasm Proteins; D053244:Osteoprotegerin; D011509:Proteoglycans; D018160:Receptors, Cytoplasmic and Nuclear; D018124:Receptors, Tumor Necrosis Factor; C508241:SDC1 protein, human; D053668:Syndecan-1; D053667:Syndecans; C506030:TNFRSF11B protein, human; D001613:beta 2-Microglobulin; D016222:Fibroblast Growth Factor 2; D014750:Vincristine; D003907:Dexamethasone; D004317:Doxorubicin; D003520:Cyclophosphamide; D000077268:Pamidronate; D008558:Melphalan; D011241:Prednisone