title: Circulating levels and clinical significance of soluble CD86 in myeloma patients.
abstract: Circulating soluble CD86 (sCD86) levels are elevated in a number of leukaemias and are an independent prognostic factor in acute myeloid leukaemia. We investigated the clinical significance of circulating sCD86 in 299 patients from the UK Medical Research Council myeloma VIth trial, where patients received ABCM [adriamycin, carmustine (BCNU), cyclophosphamide, melphalan] either alone or with prednisolone (ABCM + P). Serum levels of sCD86 were significantly elevated (P = 0.0001) in myeloma patients and using the median normal donor level (0.621 ng/ml) as a cut-off point, 70% of patients had elevated levels (range = 0.015-15.87 ng/ml, median = 1.1 ng/ml). In univariate analysis elevated sCD86 levels were associated with significantly shorter (P < 0.001) survival (median = 22 vs. 51 months) and event-free survival (median = 14 vs. 31 months) in ABCM + P but not ABCM patients. Multivariate analysis demonstrated that sCD86 was a significant, independent prognostic marker of both overall [risk ratio (RR) = 2.04, P = 0.0006] and event-free (RR = 1.95, P = 0.0004) survival in ABCM + P patients. In conclusion, this study demonstrated that sCD86 levels are a significant independent prognostic marker in at least some myeloma treatment groups and its biological role and prognostic value should be further investigated.
authors.affiliation: Haematology Research Group, Christchurch School of Medicine, PO Box 4345, Christchurch, New Zealand. barry.hock@chmeds.ac.nz
authors.forename: B D
authors.initials: BD
authors.lastname: Hock
authors.forename: M
authors.initials: M
authors.lastname: Drayson
authors.forename: W N
authors.initials: WN
authors.lastname: Patton
authors.forename: K
authors.initials: K
authors.lastname: Taylor
authors.forename: L
authors.initials: L
authors.lastname: Kerr
authors.forename: J L
authors.initials: JL
authors.lastname: McKenzie
mesh_terms: D000328:Adult; D000368:Aged; D000951:Antigens, Neoplasm / Q000097:blood*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D051940:B7-2 Antigen / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D002330:Carmustine / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy / Q000276:immunology*; D011239:Prednisolone / Q000627:therapeutic use; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D000951:Antigens, Neoplasm; D051940:B7-2 Antigen; D014408:Biomarkers, Tumor; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone; D008558:Melphalan; D002330:Carmustine