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Elevated serum FGF23 concentrations in plasma cell dyscrasias
Inge Stewart1, Claire Roddie, Anthony Gill
1Cancer Genetics Department, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, NSW 2065, Australia.
Bone
|April 29, 2006
Summary
Fibroblast growth factor 23 (FGF23) is elevated in B-cell neoplasms like myeloma. This study found FGF23 in plasma cells but no hypophosphatemia, suggesting limited systemic activity.
Area of Science:
- Endocrinology
- Oncology
- Hematology
Background:
- Fibroblast growth factor 23 (FGF23) regulates phosphate metabolism.
- Elevated FGF23 is linked to oncogenic osteomalacia from mesenchymal tumors.
- Hypophosphatemia is rare in non-mesenchymal tumors.
Observation:
- FGF23 levels were examined in B-cell neoplasms.
- Elevated FGF23 was found in patients with myeloma and monoclonal gammopathy of undetermined significance (MGUS).
- FGF23 levels correlated with paraprotein and beta-2 microglobulin.
Findings:
- Hypophosphatemia was absent despite elevated FGF23.
- A weak positive correlation existed between FGF23 and phosphate.
- Malignant plasma cells expressed cytoplasmic FGF23.
Implications:
- FGF23 produced by clonal B-cells may lack systemic bioactivity.
- Other factors might maintain serum phosphate levels in these patients.
- The FGF23-skeletal disease link in plasma cell dyscrasias warrants further investigation.