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[Relativity in multiple myeloma and KL-6]

Chikashi Matsuda1, Takaaki Miyake, Tuyoshi Araki

  • 1Central Clinical Laboratory, Shimane University Hospital, Izumo 693-8501, Japan. matsuda8@med.shimane-u.ac.jp

Rinsho Byori. the Japanese Journal of Clinical Pathology
|March 16, 2012
PubMed

Insights

Elevated serum KL-6 levels can indicate lung injury or multiple myeloma. This study identified a specific myeloma cell marker (CD19/CD56 double negative) associated with high KL-6, aiding differential diagnosis.

Area of Science:

  • Oncology
  • Pulmonology
  • Clinical Chemistry

Background:

  • KL-6, a high-molecular-weight mucinous glycoprotein, is recognized as a biomarker for lung injury, particularly in interstitial pneumonia.
  • Elevated KL-6 levels are typically associated with pulmonary conditions, necessitating careful interpretation in other clinical contexts.

Purpose of the Study:

  • To report a case of multiple myeloma with significantly elevated serum KL-6 levels.
  • To investigate the association between specific multiple myeloma cell characteristics and elevated KL-6 concentrations.
  • To highlight the importance of differentiating multiple myeloma from interstitial pneumonia when high KL-6 levels are detected.

Main Methods:

  • Case presentation of a multiple myeloma patient with high serum KL-6.
  • Analysis of blood test profiles and serum KL-6 concentrations in 20 multiple myeloma patients.
  • Flow cytometry analysis to characterize myeloma cell surface markers (CD19, CD56, CD38).

Main Results:

  • A case of Bence-Jones lambda type multiple myeloma presented with a serum KL-6 level of 19,400 U/ml.
  • Five out of 20 multiple myeloma patients exhibited elevated KL-6 levels.
  • All five patients with elevated KL-6 had myeloma cells with a CD19/CD56 double-negative fraction and high CD38 expression.

Conclusions:

  • High serum KL-6 levels can be observed in multiple myeloma, not exclusively in interstitial pneumonia.
  • The presence of CD19/CD56 double-negative, CD38-high myeloma cells may be a specific indicator of elevated KL-6 in multiple myeloma.
  • Clinical differentiation between interstitial pneumonia and multiple myeloma is crucial when elevated serum KL-6 is encountered.

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