Serum hyaluronan in patients with multiple myeloma: Correlation with survival and Ig concentration

Serum from 386 myeloma patients were analyzed for serum hyaluronan (HYA) at diagnosis. Median age was 68 years (range, 32 to 87 years). The distributi on of Ig classes was typical (58% IgG, 21% IgA, 1% IgD, and 20% light chain disease). The patients comprised 58% in stage III, 33% in stage II, and 9% in stage I, The majority (82%) had HYA values within an intermediate range (10 to 120 mu g/L), 13% had high values (>120 mu g/L), and 5% had abnormal ly low values (0 to 9 mu g/L), For the first time, a patient group with abn ormally low HYA serum values is reported. An inverse correlation between su rvival and HYA serum level was found (P = .015), When tested separately, pa tients with abnormally low or high HYA values had significantly shorter med ian survival (21.1 and 19.7 months, respectively) than those with an interm ediate HYA concentration (32.6 months; P = .005), Patients with abnormally low or high HYA levels had more advanced disease as judged by staging and b iochemical markers. Interestingly, there was an inverse correlation between the HYA value and the M-component concentration in serum. Fifty percent of patients with abnormally low HYA values had IgA myelomas. In conclusion, t he serum concentration of HYA may be of prognostic value in selected cases of multiple myeloma. Further studies will be performed to elucidate possibl e explanations for our findings, especially those related to the HYA cell s urface binding proteins, (C) 1999 by The American Society of Hematology.