title: Clinical utility of C-terminal telopeptide of type 1 collagen in multiple myeloma.
abstract: Myeloma bone disease (MBD) is a major cause of morbidity in multiple myeloma (MM). We investigated bone turnover markers (BTM) as relapse predictors and biomarkers for monitoring MBD. We measured C-terminal telopeptide of type I collagen (CTX-1), and Procollagen type 1 N Propeptide (P1NP) in 86 MM patients and 26 controls. CTX-1 was higher in newly diagnosed patients compared to control, remission and relapse (P < 0·05), and decreased following treatment. In the setting of relapse, a CTX-1 rise greater than the calculated least significant change (LSC) was observed in 26% of patients 3-6 months prior to relapse (P = 0·007), and in 60·8% up to 3 months before relapse (P = 0·015). Statistically significant changes in CTX-1 levels were also observed in patients who were with and without bisphosphonate therapy at the time of relapse. In patients with normal renal function, mean CTX-1 level was highest in the newly diagnosed group (0·771 ± 0·400 μg/l), and lowest in the remission group (0·099 ± 0·070 μg/l) (P < 0·0001). P1NP levels were not statistically different across the patient groups. We conclude that CTX-1, measured on an automated hospital laboratory platform, has a role in routine treatment monitoring and predicting relapse of MBD, even in patients on bisphosphonates.
authors.affiliation: Department of Haematology, Mater Misericordiae University Hospital, Dublin 7, Ireland.|National Institute for Cellular Biotechnology, Dublin City University, Dublin 9, Ireland.
authors.forename: Kay R
authors.initials: KR
authors.lastname: Ting
authors.affiliation: Department of Clinical Chemistry and Diagnostic Endocrinology, Mater Misericordiae University Hospital, Dublin 7, Ireland.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Brady
authors.affiliation: Department of Haematology, Mater Misericordiae University Hospital, Dublin 7, Ireland.|National Institute for Cellular Biotechnology, Dublin City University, Dublin 9, Ireland.
authors.forename: Abdul
authors.initials: A
authors.lastname: Hameed
authors.affiliation: Department of Haematology, Mater Misericordiae University Hospital, Dublin 7, Ireland.|National Institute for Cellular Biotechnology, Dublin City University, Dublin 9, Ireland.
authors.forename: Giao
authors.initials: G
authors.lastname: Le
authors.affiliation: National Institute for Cellular Biotechnology, Dublin City University, Dublin 9, Ireland.
authors.forename: Justine
authors.initials: J
authors.lastname: Meiller
authors.affiliation: Department of Haematology, Mater Misericordiae University Hospital, Dublin 7, Ireland.
authors.forename: Estelle
authors.initials: E
authors.lastname: Verburgh
authors.affiliation: Department of Haematology, Mater Misericordiae University Hospital, Dublin 7, Ireland.
authors.forename: Christopher
authors.initials: C
authors.lastname: Bayers
authors.affiliation: Department of Haematology, Mater Misericordiae University Hospital, Dublin 7, Ireland.
authors.forename: Dalia
authors.initials: D
authors.lastname: Benjamin
authors.affiliation: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.|Department of Medicine, Harvard Medical School, Boston, MA, USA.
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Anderson
authors.affiliation: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.|Department of Medicine, Harvard Medical School, Boston, MA, USA.
authors.forename: Paul G
authors.initials: PG
authors.lastname: Richardson
authors.affiliation: National Institute for Cellular Biotechnology, Dublin City University, Dublin 9, Ireland.|Department of Biology, Maynooth University, Co. Kildare, Ireland.
authors.forename: Paul
authors.initials: P
authors.lastname: Dowling
authors.affiliation: National Institute for Cellular Biotechnology, Dublin City University, Dublin 9, Ireland.
authors.forename: Martin
authors.initials: M
authors.lastname: Clynes
authors.affiliation: Department of Clinical Chemistry and Diagnostic Endocrinology, Mater Misericordiae University Hospital, Dublin 7, Ireland.
authors.forename: Maria C
authors.initials: MC
authors.lastname: Fitzgibbon
authors.affiliation: Department of Haematology, Mater Misericordiae University Hospital, Dublin 7, Ireland.|National Institute for Cellular Biotechnology, Dublin City University, Dublin 9, Ireland.|School of Medicine & Medical Science, University College Dublin, Dublin 4, Ireland.
authors.forename: Peter
authors.initials: P
authors.lastname: O'Gorman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001847:Bone Diseases / Q000097:blood* / Q000188:drug therapy; D024042:Collagen Type I / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood* / Q000188:drug therapy; D009363:Neoplasm Proteins / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011347:Procollagen / Q000097:blood*
chemical_list: D024042:Collagen Type I; D009363:Neoplasm Proteins; D010446:Peptide Fragments; D011347:Procollagen; C047202:procollagen Type I N-terminal peptide
keywords: CTX-1; bone markers; bone resorption; multiple myeloma; myeloma bone disease