title: Prognostic value of urinary pyridinium crosslinks and their derivatives in multiple myeloma.
abstract: Bone disease is a common feature of multiple myeloma (MM). The goal of this study was to assess the prognostic significance of urinary markers of bone metabolism in MM. Urinary levels of total pyridinoline (T-Pyd), deoxypyridinoline (T-Dpd), crosslinked N-telopeptide (Ntx), C-telopeptide (Ctx) of type I collagen and immunologic free deoxypyridinoline (f-Dpd) were assessed in 82 consecutive, previously untreated MM patients (aged 65-75 years) diagnosed between June 1995 and December 1998. A correlation between disease stage according to the Durie-Salmon classification and T-Pyd (p=0.034) and T-Dpd (p=0.007) was observed, while T-Pyd (p=0.015) and to a lesser extent f-Dpd (p=0.081) were correlated to bone involvement measured by plain X-ray. None were correlated to M-component or magnetic resonance imaging (MRI). In univariate analysis high T-Pyd (p=0.007), T-Dpd (p=0.027), f-Dpd (p<0.001), and Ctx (p=0.011) were associated with shorter overall survival, whereas only f-Dpd (p=0.0025) was associated with a shorter disease-free survival. In multivariate analysis, C-reactive protein and f-Dpd were independent prognostic factors for overall survival. This retrospective analysis defined new independent prognostic indicators of survival in patients with newly diagnosed myeloma. Indeed, urinary markers of bone resorption can easily be measured at diagnosis and have independent prognostic significance to refine the prognosis of MM patients.
authors.affiliation: Centre Hospitalier Mouscron, Mouscron, Belgium.
authors.forename: Khalil Kargar
authors.initials: KK
authors.lastname: Samani
authors.forename: Michel
authors.initials: M
authors.lastname: Brazier
authors.forename: Claire
authors.initials: C
authors.lastname: Mathiot
authors.forename: Saïd
authors.initials: S
authors.lastname: Kamel
authors.forename: Jacques
authors.initials: J
authors.lastname: Jamart
authors.forename: Jerome
authors.initials: J
authors.lastname: Jaubert
authors.forename: Michel
authors.initials: M
authors.lastname: Blanc
authors.forename: Isabelle
authors.initials: I
authors.lastname: Azaïs
authors.forename: Thierry
authors.initials: T
authors.lastname: Facon
authors.forename: Xavier
authors.initials: X
authors.lastname: Leleu
mesh_terms: D000368:Aged; D000596:Amino Acids / Q000652:urine; D015415:Biomarkers / Q000652:urine; D001862:Bone Resorption / Q000175:diagnosis* / Q000209:etiology / Q000652:urine; D003094:Collagen / Q000652:urine; D024042:Collagen Type I; D005260:Female; D006801:Humans; D008297:Male; D009101:Multiple Myeloma / Q000150:complications* / Q000401:mortality / Q000652:urine; D010455:Peptides / Q000652:urine; D011237:Predictive Value of Tests; D011379:Prognosis; D011726:Pyridinium Compounds / Q000652:urine*; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D000596:Amino Acids; D015415:Biomarkers; D024042:Collagen Type I; D010455:Peptides; D011726:Pyridinium Compounds; C052929:collagen type I trimeric cross-linked peptide; C015484:pyridinoline; C036020:deoxypyridinoline; D003094:Collagen