Annibali O, Petrucci M T, Santini D, Bongarzoni V, Russano M, Pisani F, Venditti O, Pantano F, Rago A, Siniscalchi A, Cerchiara E, Franceschini L, De Rosa L, Mariani M, Andriani S, Cudillo L, Garcia M, Cantonetti M, Mohamed S, Anaclerico B, Caravita T, Stocchi F, Cimino G, Gumenyuk S, Vozella F, Avvisati G
Gruppo Mieloma Lazio, Italy.
Oncologia Medica, Università Campus Bio Medico di Roma, Italy.
J Bone Oncol. 2020 Nov 18;26:100338. doi: 10.1016/j.jbo.2020.100338. eCollection 2021 Feb.
Bone involvement in Multiple Myeloma results from increased osteoclast formation and activity that occurs in proximity to myeloma cells. The role of Alkaline Phosphatse (ALP) in this process and the diagnostic significance of plasma levels in patients with MM are unclear.
To compare plasma ALP levels in patients with MM and solid cancers and metastatic lesions to the bone.
In this observational retrospective study we enrolled 901 patients were enrolled: 440 patients (49%) with Multiple Myeloma, 461 (51%) with solid cancers. All 901 patients had bone lesions. Among patients with Multiple Myeloma, ALP values were mainly in the range of normality than those observed in patients with solid cancers and bone lesions. This difference is independent of stage, number and type of bone lesions.
This study suggests that plasma ALP has a different clinical significance in MM than in other neoplasms and could be used as a discriminating marker in presence of bone lesions. In particular, lower or normal values, should suggest further investigations such as urinary and serum electrophoresis, associated with bone marrow aspirate in case of the presence of a monoclonal component, in order to confirm or exclude a MM diagnosis.
多发性骨髓瘤中的骨受累是由于骨髓瘤细胞附近破骨细胞形成增加和活性增强所致。碱性磷酸酶（ALP）在此过程中的作用以及MM患者血浆水平的诊断意义尚不清楚。
比较MM患者与实体癌及骨转移瘤患者的血浆ALP水平。
在这项观察性回顾性研究中，我们纳入了901例患者：440例（49%）多发性骨髓瘤患者，461例（51%）实体癌患者。所有901例患者均有骨病变。在多发性骨髓瘤患者中，ALP值主要处于正常范围内，低于实体癌和骨病变患者。这种差异与骨病变的分期、数量和类型无关。
本研究表明，血浆ALP在MM中的临床意义与其他肿瘤不同，可作为存在骨病变时的鉴别标志物。特别是，较低或正常的值应提示进一步检查，如尿液和血清电泳，若存在单克隆成分则结合骨髓穿刺，以确认或排除MM诊断。
