SST2 AS A PREDICTOR OF STATIN TREATMENT EFFICACY IN PATIENTS WITH MULTIPLE MYELOMA

to investigate an interrelationship between pre-treatment circulating form of suppression of tumorigenicity-2 (ST2) level and one-year survival rate, cardiovascular events in subjects with multiple myeloma. Ninety-seven subjects with full or partial remission of multiple myeloma were enrolled in the study. During observation period progression of multiple myeloma was proved in 25 patients, 5 persons were excluded for poor followup. 67 patients were included into statistical analysis. Patients were divided into 2 groups based on whether or not statins were included in their treatment: a statin group (n=31) and a no statin group (n=36). Among patients in the statin group, 19 patients received 20 mg/day atorvastatin and 12 patients received 40 mg/ day atorvastatin. None of the patients had received any lipidmodulating medications, including statins or fibrates, before enrollment. Observation period was up to 1 year. Blood samples for biomarkers measurements were collected. ELISA method for measurements of circulating level of sST2, interleukin-6 and NT-pro-brain natriuretic peptide were used. Lipid lowering effect in statin user was associates with declined serum sST2 level, whereas in not statin users similar response was not appeared. No changes in hemodynamics and other biomarkers between both cohorts were found. Univariate logistic regression had exhibited that sST2 (odds ratio [OR] = 1.27; 95% CI = 1.04-1.39; P = 0.002), NT-proBNP (OR = 1.06; 95% CI 1.03-1.11; P < 0.05) and statin therapy (OR=1.05; 95% CI = 1.02-1.10; P = 0.03) predicted one-year cumulative CV events. After adjustment on statin therapy, sST2 remained independent predictor one-year cumulative cardiovascular events (OR = 1.11; 95% CI = 1.08-1.15; P = 0.01). When initial sST2 level has incorporated into prediction model, statin therapy was found as predictor for improving survival in patients with elevated serum sST2 level (>37 ng/ml). Elevated pre-treatment sST2 level may by a powerful predictor of positive effect of statins on survival in patients with regression of multiple myeloma.