[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
Summary
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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