Document Detail


Plasma cell labeling index and beta 2-microglobulin predict survival independent of thymidine kinase and C-reactive protein in multiple myeloma.
MedLine Citation:
PMID:  8507875     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The plasma cell labeling index (PCLI) and serum beta 2-microglobulin (beta 2M) are independent prognostic factors in multiple myeloma (MM). Recently, levels of thymidine kinase (TK) and C-reactive protein (CRP) have been shown to have prognostic value. We studied 107 patients with newly diagnosed myeloma to determine whether TK and CRP values added prognostic information not already available using the PCLI and beta 2M. Univariate survival analysis showed prognostic significance for the PCLI, TK, beta 2M, age, serum albumin, and CRP. Multivariate analysis showed that only PCLI and beta 2M have independent prognostic significance. The survival curves were better separated using the PCLI and beta 2M than with other combinations of variables. Among nine patients under age 65 with low PCLI and low beta 2M, eight were alive almost 6 years after starting chemotherapy. These good-risk patients could not be identified by standard clinical features. Although creatinine and calcium were normal, other features such as bone lesions, osteoporosis, fracture, and anemia were present and stage distribution was similar to other patients in the study. In conclusion, PCLI and beta 2M measured at diagnosis are independent prognostic factors. They must be considered when interpreting the results of clinical trials and should be helpful in counseling patients and in designing new trials. When the PCLI and beta 2M values are known, the TK and CRP values do not add useful additional prognostic information.
Authors:
P R Greipp; J A Lust; W M O'Fallon; J A Katzmann; T E Witzig; R A Kyle
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Blood     Volume:  81     ISSN:  0006-4971     ISO Abbreviation:  Blood     Publication Date:  1993 Jun 
Date Detail:
Created Date:  1993-07-14     Completed Date:  1993-07-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7603509     Medline TA:  Blood     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  3382-7     Citation Subset:  AIM; IM    
Affiliation:
Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, MN 55905.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Bone Marrow / pathology
C-Reactive Protein / metabolism*
Female
Fluorescent Antibody Technique
Humans
Male
Middle Aged
Multiple Myeloma / blood*,  mortality,  pathology
Multivariate Analysis
Plasma Cells / pathology*
Prognosis
Survival Rate
Thymidine Kinase / blood*
beta 2-Microglobulin / metabolism*
Chemical
Reg. No./Substance:
0/beta 2-Microglobulin; 9007-41-4/C-Reactive Protein; EC 2.7.1.21/Thymidine Kinase
Comments/Corrections
Comment In:
Blood. 1993 Dec 1;82(11):3507-8   [PMID:  8241520 ]

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