title: [The analysis of thrombopoietin and clinical parameters as a marker for disease progression in patients with multiple myeloma].
abstract: BACKGROUND
  Multiple myeloma (MM) causes the suppression of hematopoiesis because of malignant cells in the bone marrow. Thrombopoietin (TPO) is regulated by a feedback mechanism with platelets. Recently, it was suggested that an elevated TPO without thrombocytopenia was associated with impaired hematopoiesis. We evaluated whether TPO levels could be a marker for disease progression in MM.
  
  
  METHODS
  The TPO levels were measured in 70 blood samples from 27 patients (newly/previously-diagnosed patients=13/14). We analyzed the TPO and clinical parameters, WBC, hemoglobin, creatinine, calcium, M-protein, protein, albumin, and beta2-microglobulin. The TPO in 20 healthy controls ranged from 6 to 69 pg/mL.
  
  
  RESULTS
  The TPO levels were significantly higher in MM patients with thrombocytopenia than in patients without thrombocytopenia and the healthy controls (median TPO: 293.0 pg/mL vs 59.6 pg/mL and 35.6 pg/mL, P<0.0001). There was a negative correlation between the TPO levels and the blood cells, i.e., leukocytes (r=-0.293), hemoglobin (r=-0.378) and platelets (r=-0.508) (P<0.05). Elevated TPO were found in association with normal platelet counts (N=20). Among the samples without thrombocytopenia, especially one year after the diagnosis, the hemoglobin (10.3 vs 12.9 g/dL, P=0.025) and albumin (3.3 vs 4.0 g/dL, P=0.085) were lower and the M-protein and protein tended to be higher in patients with elevated TPO compared to those with normal TPO.
  
  
  CONCLUSIONS
  Serum TPO was elevated with thrombocytopenia and related to impaired hematopoiesis. The elevated TPO without thrombocytopenia might be considered as impaired hematopoiesis and a marker for disease progression in patients with MM.
authors.affiliation: Devision of Hematology & Medical Oncology, Department of Internal Medicine, Kyung Hee University College of Medicine, Gangdong-gu, Seoul, Korea. lj2lj2@hanmail.net
authors.forename: Jae Jin
authors.initials: JJ
authors.lastname: Lee
authors.forename: So Young
authors.initials: SY
authors.lastname: Kang
authors.forename: Woo-In
authors.initials: WI
authors.lastname: Lee
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001772:Blood Cell Count; D019963:Clinical Chemistry Tests; D018450:Disease Progression; D005260:Female; D006410:Hematopoiesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000209:etiology; D010976:Platelet Count; D011379:Prognosis; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000097:blood* / Q000150:complications; D013926:Thrombopoietin / Q000097:blood*
chemical_list: D015415:Biomarkers; D013926:Thrombopoietin