Document Detail


A low serum level of soluble tumor necrosis factor receptor p55 predicts response to thalidomide in advanced multiple myeloma.
MedLine Citation:
PMID:  15136218     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Thalidomide modulates the production of tumor necrosis factor (TNF-alpha). Soluble TNF receptors, TNFR p55 and TNFR p75, modify TNF-alpha activity. In this study, we explored the relation between soluble TNF receptors and outcome in patients with advanced multiple myeloma treated with thalidomide. DESIGN AND METHODS: The levels of soluble TNF receptor p55 and p75 were assessed in serum from 34 myeloma patients with relapsed or refractory disease before starting thalidomide treatment. Serial measurements were performed for 16 patients in serum collected during treatment. RESULTS: The pre-treatment serum level of soluble TNFR p55 in thalidomide responders was significantly lower than that in non-responders (median 1.75 ng/mL (range 1.19-2.84) vs. 2.79 ng/mL (1.36-5.51), p=0.004). The levels of p55 declined significantly during treatment. The levels of p75 showed the same pattern as p55, but the differences were not significant. The median survival of myeloma patients with pre-treatment levels of p55 < 2.79 ng/mL was 404 days; the median survival of patients with pre-treatment levels >or= 2.79 ng/mL was shorter (65 days, log-rank test p=0.02). INTERPRETATION AND CONCLUSIONS: We conclude that soluble TNFR p55 is an adverse prognostic factor in myeloma patients with relapsed or refractory disease treated with thalidomide. Patients with a low pre-treatment level of this receptor have a better response rate and a longer overall survival.
Authors:
Anne-Tove Brenne; Lene Hejna Romstad; Peter Gimsing; Gunnar Juliusson; Ingemar Turesson; Pål Romundstad; Magne Borset; Anders Sundan; Anders Waage
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Haematologica     Volume:  89     ISSN:  1592-8721     ISO Abbreviation:  Haematologica     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-05-11     Completed Date:  2006-04-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0417435     Medline TA:  Haematologica     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  552-6     Citation Subset:  IM    
Affiliation:
Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, MTFS, N-7489 Trondheim, Norway. anne-tove.brenne@medisin.ntnu.no
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Dose-Response Relationship, Drug
Female
Humans
Immunosuppressive Agents / therapeutic use*
Logistic Models
Male
Middle Aged
Multiple Myeloma / blood*,  diagnosis,  drug therapy*
Prognosis
Receptors, Tumor Necrosis Factor, Type I / blood*
Receptors, Tumor Necrosis Factor, Type II / blood
Survival Rate
Thalidomide / therapeutic use*
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents; 0/Receptors, Tumor Necrosis Factor, Type I; 0/Receptors, Tumor Necrosis Factor, Type II; 50-35-1/Thalidomide

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