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The prognostic value of soluble interleukin-6 receptor in patients with multiple myeloma
1Department of Medical Sciences, Regina Apostolorum Hospital, Albano Laziale, Italy.
Background:
The effect of interleukin-6 (IL-6), the major growth factor for myeloma cells, may be enhanced by soluble IL-6 receptor (sIL-6R). Therefore, the current study investigated the clinical significance of serum sIL-6R in patients with multiple myeloma (MM).
Methods:
Serum levels of sIL-6R were determined by enzyme-linked immunoassay in 55 normal controls, 81 individuals with monoclonal gammopathy of undetermined significance (MGUS), and 164 patients with MM in various phases of the disease.
Results:
sIL-6R concentrations were higher in MM patients (162.0 +/- 134.6 ng/mL) than in individuals with MGUS (58.9 +/- 36.7 ng/mL) or in controls (45.6 +/- 22.3 ng/mL) (P = 0.0000). sIL-6R was not found to have a significant linear correlation with any other parameter, including IL-6, beta2-microglobulin (beta2-m), and neopterin, either in newly diagnosed cases or during the course of the disease. In addition, there were no statistically significant differences in sIL-6R concentrations between the clinical stages at the time of diagnosis. In univariate logistic regression analysis sIL-6R was a significant but weak prognostic indicator (P = 0.000000). Kaplan-Meier analysis showed that elevated levels of sIL-6R were associated with shorter survival (P = 0.00282). Patients also were stratified according to their serum beta2-m and sIL-6R levels. Patients with low levels of both parameters had a clear survival benefit over the other groups (P = 0.000000).
Conclusions:
The correlation between sIL-6R levels and survival is significant but weak, making it unlikely to be of much value in predicting the outcome of patients with MM alone. The results of the current study support the role of sIL-6R levels in improving the prognostic value of beta2-m and in discriminating patients with MM from individuals with MGUS.
Insights
Serum soluble interleukin-6 receptor (sIL-6R) is elevated in multiple myeloma (MM) patients and associated with shorter survival. However, sIL-6R improves the prognostic value of beta2-microglobulin for MM outcomes.
Area of Science:
- Hematology
- Oncology
- Immunology
Background:
- Interleukin-6 (IL-6) is a key growth factor for myeloma cells.
- Soluble IL-6 receptor (sIL-6R) may enhance IL-6 activity.
- The clinical significance of serum sIL-6R in multiple myeloma (MM) requires investigation.
Purpose of the Study:
- To investigate the clinical significance of serum sIL-6R in patients with MM.
- To determine if serum sIL-6R levels correlate with disease status or prognosis in MM.
Main Methods:
- Serum sIL-6R levels were measured using enzyme-linked immunoassay.
- Study included 55 healthy controls, 81 individuals with monoclonal gammopathy of undetermined significance (MGUS), and 164 MM patients.
- Correlations with IL-6, beta2-microglobulin (beta2-m), and neopterin were analyzed.
Main Results:
- MM patients exhibited significantly higher serum sIL-6R levels compared to MGUS and control groups.
- sIL-6R levels did not correlate with IL-6, beta2-m, or neopterin, nor with clinical stages.
- Elevated sIL-6R was a significant but weak independent prognostic indicator for shorter survival.
Conclusions:
- Serum sIL-6R alone has limited value for predicting MM patient outcomes.
- sIL-6R enhances the prognostic utility of beta2-m in MM.
- sIL-6R levels aid in differentiating MM patients from individuals with MGUS.