Thavasu P W, Ganjoo R K, Maidment S A, Love S B, Williams A H, Malplas J S, Balkwill F R
Biological Therapy Laboratory, Imperial Cancer Research Fund, London.
Hematol Oncol. 1995 Mar-Apr;13(2):69-82. doi: 10.1002/hon.2900130204.
Plasma cytokines and immune markers were assessed during the clinical management of 42 patients with multiple myeloma, MM. Of the patients 22/42 (all with progressive disease) were studied from the time of diagnosis, through various treatment regimes, to remission, progression or death. 5/42 patients had monoclonal gammopathy of undetermined significance (MGUS), 8/42 others had either indolent MM or stable MM, and a further 7/42 with progressive disease were also studied. IL-6, TNF-alpha, IL-1 alpha, IL-1 beta, beta 2 microglobulin (beta 2M), and neopterin were estimated in bloods taken under optimal conditions for cytokine detection. The levels were compared with a panel of samples from healthy volunteers. Both immunoreactive and biologically active plasma IL-6 levels were measured. Pretreatment IL-6 levels (both immunoreactive and biologically active) were found to correlate with severity of disease. In 13/22 patients with progressive disease who had been followed from the time of diagnosis over a 12-month period or until death, pretreatment IL-6 levels were predictive of response to therapy. Elevated plasma levels of TNF-alpha, beta 2M and neopterin were found in patients with progressive multiple myeloma, and this correlated with renal impairment. The analytes measured during the course of chemotherapy did not show correlation with disease progression or response to therapy.
在42例多发性骨髓瘤（MM）患者的临床治疗过程中，对血浆细胞因子和免疫标志物进行了评估。其中22/42例患者（均为疾病进展期）从诊断开始，历经各种治疗方案，直至缓解、病情进展或死亡。5/42例患者患有意义未明的单克隆丙种球蛋白病（MGUS），8/42例其他患者患有惰性MM或稳定型MM，另外7/42例疾病进展期患者也纳入研究。在最有利于细胞因子检测的条件下采集血液样本，测定白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、白细胞介素-1α（IL-1α）、白细胞介素-1β（IL-1β）、β2微球蛋白（β2M）和蝶呤。将这些水平与一组健康志愿者的样本进行比较。同时检测了免疫反应性和生物活性血浆IL-6水平。发现治疗前IL-6水平（免疫反应性和生物活性）与疾病严重程度相关。在13/22例从诊断开始随访12个月或直至死亡的疾病进展期患者中，治疗前IL-6水平可预测治疗反应。进展性多发性骨髓瘤患者血浆TNF-α、β2M和蝶呤水平升高，且与肾功能损害相关。化疗过程中检测的分析物与疾病进展或治疗反应无相关性。
