Zhao Na, Yang Junjie
Department of Hematology, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2014 Mar;39(3):270-5. doi: 10.11817/j.issn.1672-7347.2014.03.008.
To determine the serum level of the growth differentiation factor 15 (GDF15) in multiple myeloma (MM) patients and analyze its level with other clinical parameters, and to investigate its significance in the formation, development and prognosis assessment of MM.
We used enzyme-linked immunosorbent assay (ELISA) to measure the serum level of GDF15 in an MM group (24 pre-treatment patients) and in 20 healthy controls. All patients' clinical data were collected.
The serum GDF15 level was significantly higher in the MM group [(1.37±0.64) ng/mL] than in the normal control group [(0.14±0.06) ng/mL, P<0.01]. The mean serum GDF15 level in the MM patients in ISS stage III was (1.57±0.48) ng/mL, significantly higher than that of ISS stage (I+II) [(0.77±0.34) ng/mL, P<0.05]. There was no significant positive correlation between the serum GDF15 level and serum monoclonal proteins (M protein) level, β2-microglobulin and creatinemia (P<0.05), but significant inverse correlation was found between the GDF15 level with hemoglobin concentration and platelet count respectively (P<0.05). Serum GDF15 level was not associated with patients' age, albumin, lactic dehydrogenase (LDH), C-reactive protein (CRP), calcemia or leukocyte count (P>0.05). After 3 cycles of chemotherapy, patients with a>50% reduction of M protein had a significant reduction of GDF15, while for the patients whose M protein did not decrease obviously, their corresponding serum GDF15 level increased.
The serum GDF15 level may reflect the tumor burden in the MM patients, which increases obviously, is related with ISS, positively correlated with serum M protein level, β2- microglobulin level, serum creatinine and negatively with hemoglobin concentration and platelet count. The change of serum GDF15 level has some relation with the extent of M protein reduction, suggesting it may be used as a marker for therapy response.
测定多发性骨髓瘤(MM)患者血清中生长分化因子15(GDF15)水平,并分析其与其他临床参数的关系,探讨其在MM发生、发展及预后评估中的意义。
采用酶联免疫吸附测定(ELISA)法检测24例MM预处理患者及20例健康对照者血清GDF15水平,并收集所有患者的临床资料。
MM组血清GDF15水平[(1.37±0.64)ng/mL]显著高于正常对照组[(0.14±0.06)ng/mL,P<0.01]。国际分期系统(ISS)Ⅲ期MM患者血清GDF15平均水平为(1.57±0.48)ng/mL,显著高于ISS(Ⅰ+Ⅱ)期[(0.77±0.34)ng/mL,P<0.05]。血清GDF15水平与血清单克隆蛋白(M蛋白)水平、β2微球蛋白及血肌酐无显著正相关(P<0.05),但与血红蛋白浓度及血小板计数分别呈显著负相关(P<0.05)。血清GDF15水平与患者年龄、白蛋白、乳酸脱氢酶(LDH)、C反应蛋白(CRP)、血钙或白细胞计数无关(P>0.05)。化疗3个周期后,M蛋白降低>50%的患者GDF15显著降低,而M蛋白无明显下降的患者,其相应血清GDF15水平升高。
血清GDF15水平可能反映MM患者的肿瘤负荷,其明显升高,与ISS相关,与血清M蛋白水平、β2微球蛋白水平、血清肌酐呈正相关,与血红蛋白浓度和血小板计数呈负相关。血清GDF15水平的变化与M蛋白降低程度有关,提示其可能作为治疗反应的标志物。