High plasma basic fibroblast growth factor concentration is associated with response to thalidomide in progressive multiple myeloma

The aim of this study was to define prognostic factors that might be predic tive for response to thalidomide (That) in progressive multiple myeloma (n = 54). We examined the concentration of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF), two potent heparin-bindin g mediators of angiogenesis in peripheral blood (PB; PB-VEGF and PB-bFGF) a nd bone marrow (BM; BM-VEGF and BM-bFGF), in combination with well-characte rized predictors for response and survival to chemotherapy. After a median follow-up time of 15 months (range, 0.3-20), 29 patients (pts.) showed at l east a minimal response to Thai therapy, whereas 25 pts. were nonresponsive . As shown by univariate analysis, responsive pts. had statistically signif icant higher concentrations of PB-bFGF (P = 0.009) and beta2-microglobulin (P = 0.03) before therapy, as well as lower hemoglobin (P = 0.008) and albu min (P = 0.02) levels, whereas no statistically significant difference was found for PB-VEGF (P = 0.93). When a multiple logistic regression analysis was performed, PB-bFGF was the only statistically significant predictor for response to therapy (P = 0.01). None of these variables was associated wit h a prolonged progression-free survival. In conclusion, our findings indica te that high pretreatment plasma bFGF levels in pts. with progressive multi ple myeloma are associated with unfavorable parameters of response and surv ival but nevertheless predict for response to Thal therapy.