title: Total soluble HLA class I and soluble HLA-G in multiple myeloma and monoclonal gammopathy of undetermined significance.
abstract: Serum beta2-microglobulin, the light chain of the HLA class I molecular complex, remains one of the best survival prognostic factors in multiple myeloma, but other HLA class I molecules might be of interest in monoclonal gammopathies. In this study, we evaluate total soluble HLA class I (HLA-Is) and soluble HLA-G (HLA-Gs) in 103 patients with newly diagnosed multiple myeloma, 30 patients with monoclonal gammopathy of undetermined significance (MGUS), and 30 healthy subjects, studying their prognostic value in multiple myeloma. In multiple myeloma patients, HLA-Is and HLA-Gs median values were 0.8 microg/mL and 28 ng/mL, respectively. Median HLA-Is concentration was higher in stage II and III multiple myeloma patients than in stage I multiple myeloma, MGUS, and control patients. Median HLA-Gs was significantly lower in healthy controls than in MGUS and multiple myeloma patients. A high level of HLA-Is (> or =2.1 microg/mL) was predictive of short survival (P = 0.017). For each given level of beta2-microglobulin, the relative risk of death was higher for patients with HLA-Is > or = 2.1 microg/mL than in patients with a lower level (P = 0.047). HLA-Gs, a marker of monoclonal gammopathy, was of no prognostic value, but the addition of HLA-Is to beta2-microglobulin produced an efficient prognostic score (P < 0.0001). HLA-Is is a new marker of multiple myeloma tumor load and provides additional survival prognostic information to beta2-microglobulin.
authors.affiliation: Service d'Hématologie, Lille, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Leleu
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Le Friec
authors.forename: Thierry
authors.initials: T
authors.lastname: Facon
authors.forename: Laurence
authors.initials: L
authors.lastname: Amiot
authors.forename: Renée
authors.initials: R
authors.lastname: Fauchet
authors.forename: Bernadette
authors.initials: B
authors.lastname: Hennache
authors.forename: Valérie
authors.initials: V
authors.lastname: Coiteux
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Yakoub-Agha
authors.forename: Sylvain
authors.initials: S
authors.lastname: Dubucquoi
authors.forename: Hervé
authors.initials: H
authors.lastname: Avet-Loiseau
authors.forename: Claire
authors.initials: C
authors.lastname: Mathiot
authors.forename: Régis
authors.initials: R
authors.lastname: Bataille
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Mary
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D005260:Female; D006680:HLA Antigens / Q000097:blood*; D059951:HLA-G Antigens; D015395:Histocompatibility Antigens Class I / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000473:pathology*; D010265:Paraproteinemias / Q000097:blood / Q000473:pathology*; D011379:Prognosis; D016019:Survival Analysis; D001613:beta 2-Microglobulin / Q000097:blood*
chemical_list: D006680:HLA Antigens; D059951:HLA-G Antigens; D015395:Histocompatibility Antigens Class I; D001613:beta 2-Microglobulin