A survey of prognostic value of serum factors in multiple myeloma patients before treatment: macrophage-colony stimulating factor (M-CSF) is a powerful predictor of survival.

Cytokines are involved in the pathogenesis of multiple myeloma (MM) and other cancers. The aim of this study was to evaluate a range of cytokines of diverse activity in patients with multiple myeloma for a possible prognostic value. Concentrations of the following cytokines and cytokine receptors were measured by ELISA in the sera of 64 untreated MM patients: IL-6, IL-8, IL-10, TNFα, sTNF R I and II, sIL-2Rα, IL-1ra, M-CSF, G-CSF, VEGF, and bFGF. Serum levels of sTNF RI, IL-6, and bFGF were elevated in over 50% of patients. There was an inverse relationship between sTNF RII, TNFα, IL-1ra, and albumin levels. There was no significant relationship between cytokines/cytokine receptors and other serum correlates of myeloma. In a univariate survival analysis, β2-microglobulin, LDH, sIL-2Rα, sTNF RI, and M-CSF were significant variables. In a multivariate analysis, only M-CSF and β2-microglobulin retained a significant influence on survival. Serum M-CSF may be considered another independent and clinically useful prognostic factor in multiple myeloma.