Expression and Clinical Significance of BCL2 Interacting Protein 3 Like (BNIP3L) in Serum of Patients with MM

BNIP3L regulates mitophagy and apoptosis, and its dysregulation is closely linked to the development and progression of cancers. Studies have shown that BNIP3L is valuable for assessing tumor progression and prognosis. This study aims to investigate the diagnostic and prognostic significance of serum BNIP3L levels in multiple myeloma (MM).

The serum level of BNIP3L were measured in 152 MM patients and 158 healthy controls by Enzyme-Linked Immunosorbent Assay (ELISA). Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic ability of MM. The prognostic relevance of serum BNIP3L levels in MM patients was assessed using Kaplan-Meier survival analysis and Cox regression.

Serum BNIP3L levels were significantly elevated in MM patients compared to healthy controls (P < 0.001) and demonstrated significant diagnostic value (Area Under the Curve (AUC) = 0.744). Higher BNIP3L levels correlated negatively with serum calcium (P = 0.02) and M protein (P = 0.03). MM patients with extramedullary infiltration (EMI) or high-risk cytogenetic abnormalities had higher serum BNIP3L levels compared to those without these features (all P < 0.05). BNIP3L levels were significantly higher in non-transplant patients compared to autologous stem cell transplant (ASCT) patients (P = 0.01). And patients achieving Very Good Partial Response (VGPR) efficacy had significantly lower serum BNIP3L levels than those who achieving only Partial Response (PR) (P = 0.04). Compared to patients with low serum BNIP3L levels, those with high levels exhibited a trend toward poorer overall survival (Hazard Ratio (HR) = 1.40, 95%Confidence Interval (CI): 0.47-4.19).

This study identified serum BNIP3L as a potential diagnostic biomarker for active MM. Elevated BNIP3L levels were significantly associated with adverse clinical characteristics, suboptimal treatment response, and a trend toward inferior survival. Consequently, measuring serum BNIP3L could be valuable for monitoring disease progression and prognostic evaluation in MM patients.