Serum syndecan-1: a new independent prognostic marker in multiple myeloma

Serum samples drawn at diagnosis from 174 myeloma patients were analyzed fo r the presence of the heparin sulfate proteoglycan, syndecan-1, Syndecan-1 was elevated in 79% of patients (median, 643 units/mL) compared with 40 hea lthy controls (median, 128 units/mL), P < .0001. Serum syndecan-1 correlate d with the following: serum creatinine, secretion of urine M-component over the course of 24 hours, soluble interleukin-6 (IL-6) receptor, C-terminal telopeptide of type I collagen, beta(2)-microglobulin, percentage of plasma cells in the bone marrow, disease stage, and serum M-component concentrati on. In order to evaluate syndecan-1 as a prognostic marker in multiple myel oma, it was entered into a multivariate Cox regression model. Data from 138 patients were available for this analysis. As a continuous variable, synde can-1 was an independent prognostic parameter in addition to serum beta(2)- microglobulin and World Health Organization performance status. When syndec an-1 was dichotomized by the best cutoff (66th percentile, 1170 units/mL), the survival difference between the groups was highly significant: "high" s yndecan-1 group had a median survival of 20 months, and the "low" syndecan- 1 group had a median of 44 months (P < .0001). We conclude that syndecan-1 is a new independent prognostic parameter in multiple myeloma, and its role in prognostic classification systems should be further investigated. (Bloo d. 2000;95:388-392) (C) 2000 by The American Society of Hematology.