title: Polyclonal immunoglobulin E levels are correlated with hemoglobin values and overall survival in patients with multiple myeloma.
abstract: OBJECTIVE
  Polyclonal IgG, IgA, and IgM immunoglobulins are often decreased in sera of patients with multiple myeloma (MM), whereas very few data are available on polyclonal IgE levels. We have determined IgE levels in a large series of MM patients at diagnosis and subjects with monoclonal gammopathy of undetermined significance (MGUS) and correlated IgE levels with survival and prognostic factors in MM.
  
  
  METHODS
  IgE were determined with a commercially available ELISA kit in 201 MM patients at diagnosis, 144 subjects with MGUS, and 77 age-matched controls.
  
  
  RESULTS
  IgE levels progressively decreased from controls to MGUS and from MGUS to MM (P = 0.001). MM patients with IgE levels of >11.5 IU/mL (median) had a better survival than patients with IgE of <11.5 IU/mL (P = 0.048). The difference was even more significant when MM patients were divided according to clinical cutoff values. Patients with elevated IgE levels (>100 IU/mL) had from 2 to 3 years longer survival than those with low (<10 IU/mL) or intermediate values (10-100 IU/mL; P < 0.01). IgE levels were positively and negatively correlated with hemoglobin (P = 0.006) and beta2-microglobulin levels (P = 0.007), respectively. Univariate and multivariate analyses confirmed that high IgE levels are positive predictors of overall survival (P = 0.03 and 0.08, respectively) and strongly correlated with hemoglobin values.
  
  
  CONCLUSIONS
  Because IgE levels are dependent on Th(2) responses, these data open new perspectives in the interpretation of antitumor immune responses and pathogenesis of anemia in MM.
authors: Divisione di Ematologia dell Universita di Torino, Ospedale San Giovanni Battista, Torino, Italy. giorgia.matta@unito.it
authors: Giorgia Maria Elena
authors: GM
authors: Matta
authors: Silvano
authors: S
authors: Battaglio
authors: Cristiana
authors: C
authors: Dibello
authors: Patrizia
authors: P
authors: Napoli
authors: Cristina
authors: C
authors: Baldi
authors: Giovannino
authors: G
authors: Ciccone
authors: Marta
authors: M
authors: Coscia
authors: Mario
authors: M
authors: Boccadoro
authors: Massimo
authors: M
authors: Massaia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality*; D010265:Paraproteinemias / Q000276:immunology; D011379:Prognosis
chemical_list: D006454:Hemoglobins; D007073:Immunoglobulin E