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[Acute phase proteins in monoclonal gammapathies]
J J Dubost1, J M Ristori, M Soubrier
1Unité d'Immunologie Clinique, Hôpital Saint-Jacques, Clermont-Ferrand, France.
Pathologie-Biologie
|October 1, 1991
Summary
Interleukin-6 (IL-6) drives plasma cell growth and C-reactive protein (CRP) production. Elevated acute-phase reactants, including CRP, indicate active disease in multiple myeloma and Waldenström's macroglobulinemia.
Area of Science:
- Biochemistry
- Immunology
- Hematology
Context:
- Interleukin-6 (IL-6) is a key cytokine involved in B-cell maturation and inflammation.
- Acute-phase reactants (APRs) are proteins whose plasma concentrations increase or decrease by 25% or more during inflammatory states.
- Monoclonal gammopathies, including multiple myeloma, MGUS, and Waldenström's macroglobulinemia, are characterized by the proliferation of a single clone of immunoglobulin-producing plasma cells.
Purpose:
- To investigate the role of acute-phase reactants as markers of disease activity in monoclonal gammopathies.
- To correlate levels of specific APRs with disease status in multiple myeloma, MGUS, and Waldenström's macroglobulinemia.
- To assess the utility of a biologic inflammatory syndrome, defined by variations in APRs, in reflecting disease activity.
Summary:
- Eight acute-phase proteins were measured in patients with multiple myeloma (n=51), MGUS (n=17), and Waldenström's macroglobulinemia (n=5).
- Elevated C-reactive protein (CRP) levels were observed in 27% of myeloma patients and 39% with active disease. Fibrinogen, alpha-1-antitrypsin, and orosomucoid were significantly higher in myeloma versus MGUS.
- A biologic inflammatory syndrome was present in 41% of myeloma patients and 60% of Waldenström's patients, correlating with active disease.
Impact:
- Acute-phase reactants, particularly CRP, serve as valuable markers for monitoring disease activity in multiple myeloma.
- The findings suggest that APRs, similar to IL-6, can indicate the inflammatory status and disease progression in monoclonal gammopathies.
- This study highlights the potential of APRs in clinical practice for assessing disease burden and guiding treatment decisions in hematologic malignancies.