CONCENTRATIONS OF SOLUBLE TUMOR-NECROSIS-FACTOR RECEPTORS, BETA-2-MICROGLOBULIN, IL-6 AND TNF IN SERUM OF MULTIPLE-MYELOMA PATIENTS AFTER CHEMOTHERAPY AND AFTER COMBINED ENZYME-CHEMOTHERAPY

The remission lime of multiple myeloma (MM) patients after chemotherap y and after enzyme-chemotherapy were compared retrospectively. The rem ission time was significantly (p<0.0001) longer in stage ii enzyme-tre ated patients. We determined soluble TNF-receptors (sTNF-Rs), p55 and p75; beta 2-microglobulin (beta 2M); interleukin-6 (IL-6) and tumor ne crosis factor (TNF) in the sera of 198 patients with MM stage I-III. T his was done before therapy; after chemotherapy (MOCCA/VMCP); or after enzyme-chemotherapy (Wobe-Mugos(R), consisting of chymotrypsin, tryps in, papain), and in 67 age-matched healthy volunteers. The serum conce ntrations of sTNF-Rs and beta 2M were significantly (p<0.05) elevated in stage ii and iii patients before therapy; sTNF-Rs and beta 2M corre late (r=0.886, p<0.001 for sTNF-R p55 vs. beta 2M; and r=0.835 p<0.001 for sTNF-R p75 vs. beta 2M). The levels of these serum proteins were lower after chemotherapy (stage II p55: p<0.1; p75: p<0.1; stage III p 55: p<0.1; p75: p<0.05), and significantly lower after enzyme-chemothe rapy (beta 2M: p<0.1; p55: p<0.05; p75: p<0.05), During the course of the study (17 months), beta 2M, p55 and p75 levels in 52 MM stage II p atients (chemotherapy or enzyme-chemotherapy) were compared. A signifi cant reduction in marker concentration was only observed in MM patient s' sera treated with enzyme-chemotherapy (p<0.001). A correlation betw een the concentration of bioactive IL-6 and immunoreactive IL-6 exists (r=0.78; p<0.05). No differences in IL-6 concentrations were detected between the treatment groups. The concentration of bioactive TNF was elevated in stage I (all therapies) only: the immunoreactive TNF was e levated in ail three stages and treatment groups. Enzyme-chemotherapy prolongs remission times in stage ii MM patients and reduces the conce ntration oi progression markers sTNF-R and beta 2M.