title: Serum YKL-40: a new independent prognostic marker for skeletal complications in patients with multiple myeloma.
abstract: In a time of increasing treatment options for multiple myeloma bone disease, risk factors predicting progression need to be elucidated. This study investigated the value of serum YKL-40, previously shown to be associated with radiographic progression of bone destruction, as a predictor for time to clinical progression, i.e. skeletal-related events (SREs), in 230 newly diagnosed patients with multiple myeloma receiving intravenous bisphosphonates. Serum concentrations of YKL-40 and biochemical bone markers (CTX-MMP, CTX-I, PINP) were measured at diagnosis. Patients were evaluated every third month for SRE and at 9 and 24 months for radiographic progression. Elevated serum YKL-40 was seen in 47% of patients and associated with high-risk disease (International Staging System stage III; p < 0.001), increased bone resorption (serum CTX/MMP; p < 0.001) and early radiographic progression at 9 months (p = 0.01). Serum YKL-40 together with serum CTX-MMP/PINP ratio and World Health Organization status were independent predictors of time to first SRE.
authors.affiliation: a Department of Hematology , Rigshospitalet, University of Copenhagen , Copenhagen , Denmark.
authors.forename: Anne K
authors.initials: AK
authors.lastname: Mylin
authors.affiliation: b Department of Hematology , Odense University Hospital , Odense , Denmark.
authors.forename: Niels
authors.initials: N
authors.lastname: Abildgaard
authors.affiliation: c Departments of Medicine and Oncology , Herlev Hospital, University of Copenhagen , Herlev , Denmark.
authors.forename: Julia S
authors.initials: JS
authors.lastname: Johansen
authors.affiliation: d Department of Clinical Biochemistry , Aarhus University Hospital , Aarhus , Denmark.
authors.forename: Lene
authors.initials: L
authors.lastname: Heickendorff
authors.affiliation: e Department of Biostatistics , University of Copenhagen , Copenhagen , Denmark.
authors.forename: Svend
authors.initials: S
authors.lastname: Kreiner
authors.affiliation: f Department of Hematology , St Olav Hospital, Norwegian University of Science and Technology , Trondheim , Norway.
authors.forename: Anders
authors.initials: A
authors.lastname: Waage
authors.affiliation: g Department of Hematology , Skane University Hospital , Malmö , Sweden.
authors.forename: Ingemar
authors.initials: I
authors.lastname: Turesson
authors.affiliation: a Department of Hematology , Rigshospitalet, University of Copenhagen , Copenhagen , Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Gimsing
mesh_terms: D054392:Adipokines / Q000097:blood*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015415:Biomarkers; D001847:Bone Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D000071451:Chitinase-3-Like Protein 1; D018450:Disease Progression; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D037102:Lectins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood* / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D009367:Neoplasm Staging; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D054392:Adipokines; D015415:Biomarkers; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; D037102:Lectins
keywords: CHI3L1; Multiple myeloma; YKL-40; bisphosphonates; skeletal related events