Department of Hematology, Affiliated Hospital of Nantong University, Nantong, China.
Int J Lab Hematol. 2022 Feb;44(1):135-141. doi: 10.1111/ijlh.13695. Epub 2021 Sep 22.
Renal insufficiency is one of the common complications in multiple myeloma (MM) and an independent factor indicating a poor prognosis. Cystatin C (Cys C) is considered to be expected to replace creatinine to calculate glomerular filtration rate due to its own characteristics. Gene expression analysis suggested that cystatin C is up-regulated nearly 50-fold in patients with multiple myeloma.
To further clarify the role of cystatin C in multiple myeloma, we retrospectively evaluated pretreatment cystatin C levels in 195 newly diagnosed patients through statistical analysis.
The elevation of serum cystatin C was positively related to the elevation of serum creatinine (P < .001), LDH (P = .006), β2-microglobulin (P < .001), bone marrow plasma cell proportion (P = .005) and the reduction of hemoglobin levels (P < .001). Patients with serum cystatin C levels >1.6 mg/L had a significantly shorter progression-free survival (PFS) or overall survival (OS) than patients with serum cystatin C levels <1.6 mg/L (median PFS: median unreached vs 16.7 months, P < .001; median OS: 68 months vs 42 months, P = .014). Although serum cystatin C is not an independent prognostic factor of OS and PFS in patients with multiple myeloma, serum cystatin C can be considered as a sensitive indicator to differentiate well OS and PFS in the group of ISS II patients.
Serum cystatin C is associated with tumor burden of multiple myeloma and cystatin C can further differentiate the prognosis of ISS II patients. More prospective studies are required to explore the role of serum cystatin C in multiple myeloma.
肾功能不全是多发性骨髓瘤（MM）的常见并发症之一，也是预示预后不良的独立因素。胱抑素 C（Cys C）由于自身特点，被认为有望替代肌酐来计算肾小球滤过率。基因表达分析表明，在多发性骨髓瘤患者中，胱抑素 C 的表达上调近 50 倍。
为了进一步阐明胱抑素 C 在多发性骨髓瘤中的作用，我们通过统计分析回顾性评估了 195 例新诊断患者的预处理胱抑素 C 水平。
血清胱抑素 C 的升高与血清肌酐（P<0.001）、乳酸脱氢酶（P=0.006）、β2-微球蛋白（P<0.001）、骨髓浆细胞比例（P=0.005）和血红蛋白水平降低（P<0.001）呈正相关。血清胱抑素 C 水平>1.6mg/L 的患者无进展生存期（PFS）或总生存期（OS）明显短于血清胱抑素 C 水平<1.6mg/L 的患者（中位 PFS：中位未达到比 16.7 个月，P<0.001；中位 OS：68 个月比 42 个月，P=0.014）。尽管血清胱抑素 C 不是多发性骨髓瘤患者 OS 和 PFS 的独立预后因素，但血清胱抑素 C 可作为区分 ISS II 患者 OS 和 PFS 的敏感指标。
血清胱抑素 C 与多发性骨髓瘤的肿瘤负荷有关，胱抑素 C 可进一步区分 ISS II 患者的预后。需要更多的前瞻性研究来探讨血清胱抑素 C 在多发性骨髓瘤中的作用。
