MULTIPLE-MYELOMA - AN IMMUNOCLINICAL STUDY OF DISEASE AND RESPONSE TOTREATMENT

Plasma cytokines and immune markers were assessed during the clinical management of 42 patients with multiple myeloma, MM. Of the patients 2 2/42 (all with progressive disease) were studied from the time of diag nosis, through various treatment regimes, to remission, progression or death. 5/42 patients had monoclonal gammopathy of undetermined signif icance (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-alp ha, IL-1 alpha, IL-1 beta, beta 2 microglobulin (beta 2M), and neopter in were estimated in bloods taken under optimal conditions for cytokin e detection. The levels were compared with a panel of samples from hea lthy 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 dis ease. In 13/22 patients with progressive disease who had been followed from the time of diagnosis over a 12-month period or until death, pre treatment IL-6 levels were predictive of response to therapy. Elevated plasma levels of TNF-alpha, beta 2M and neopterin were found in patie nts with progressive multiple myeloma, and this correlated with renal impairment. The analytes measured during the course of chemotherapy di d not show correlation with disease progression or response to therapy .