Observational Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2019; 7(24): 4234-4244
Published online Dec 26, 2019. doi: 10.12998/wjcc.v7.i24.4234
Expression of interleukin-32 in bone marrow of patients with myeloma and its prognostic significance
Gang Wang, Fang-Ying Ning, Jia-Heng Wang, Hai-Meng Yan, Hong-Wei Kong, Yu-Ting Zhang, Qiang Shen
Gang Wang, Jia-Heng Wang, Hong-Wei Kong, Department of Hematology, Quzhou People’s Hospital, Quzhou 324000, Zhejiang Province, China
Fang-Ying Ning, Department of Hematology, People’s Hospital of Hangzhou Medical College, Zhejiang Provincial People’s Hospital, Hangzhou 310000, Zhejiang Province, China
Hai-Meng Yan, Qiang Shen, Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Yu-Ting Zhang, Adicon Clinical Laboratories Inc., Hangzhou 310023, Zhejiang Province, China
Author contributions: Wang G and Ning FY contributed equally to this study; Wang G and Ning FY designed the research; Wang G, Ning FY, Kong HW, Zhang YT and Shen Q performed the research; Yan HM, Kong HW and Zhang YT analyzed the data; Wang G, Ning FY, Wang JH, Yan HM, Kong HW, Zhang YT and Shen Q wrote and revised the paper.
Supported by Foundation for Excellent Young Medical Talents from the Quzhou People's Hospital.
Institutional review board statement: The study was approved by the Ethics Committee of People’s Hospital of Hangzhou Medical College.
Informed consent statement: All patients included in this study gave informed consent.
Conflict-of-interest statement: There is no conflict of interest to declare.
Data sharing statement: No additional data are available.
STROBE statement: The manuscript was prepared and revised according to the STROBE statement.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Fang-Ying Ning, MD, Doctor, Department of Hematology, People’s Hospital of Hangzhou Medical College, Zhejiang Provincial People’s Hospital, No. 158 Shangtang Road, Xiacheng District, Hangzhou 310000, Zhejiang Province, China. nfy182110@aliyun.com
Received: September 8, 2019
Peer-review started: September 8, 2019
First decision: November 11, 2019
Revised: October 14, 2019
Accepted: November 27, 2019
Article in press: November 27, 2019
Published online: December 26, 2019
Abstract
BACKGROUND

The guiding effect of prognostic stratification in multiple myeloma (MM) for treatment has been increasingly emphasized in recent years. The stratification of risk factors based on the International Staging System (ISS), Durie-Salmon (DS) staging and related indicators is affected by the renal function of patients, resulting in poor performance. This study assesses the relationship between interleukin-32 (IL-32) and related risk factors in 67 patients with MM and their clinical outcomes.

AIM

To investigate the feasibility of IL-32 in evaluating prognosis in patients with MM and the factors influencing prognosis.

METHODS

This was a pragmatic, prospective observational study of patients with MM at a single center. According to IL-32 level, patients were divided into two groups. The variables under consideration included age, blood β2-microglobulin, albumin, C-reactive protein, serum calcium, serum creatinine, lactate dehydrogenase, M protein type, ISS stage, DS stage, and IL-32 levels and minimal residual disease (MRD) after induction treatment. The main outcomes were progression-free survival (PFS) and overall survival (OS).

RESULTS

IL-32 was an important factor affecting PFS and OS in patients with MM. Compared with patients with IL-32 levels ≥ 856.4 pg/mL, patients with IL-32 levels < 856.4 pg/mL had longer PFS (P = 0.0387) and OS (P = 0.0379); Univariate analysis showed that IL-32 level and MRD were significantly associated with OS and PFS (P < 0.05). Multivariate analysis showed that IL-32 levels ≥ 856.4 pg/mL and MRD positive were still independent risk factors for OS and PFS (P < 0.05).

CONCLUSION

IL-32 is valuable for assessing the prognosis of MM patients. IL-32 level combined with MRD may be a useful routine evaluation index for MM patients after treatment.

Keywords: Multiple myeloma, Interleukin-32, Minimal residual lesions, Progression-free survival, Overall survival, Prognosis

Core tip: Multiple myeloma (MM) is a heterogeneous disease with a survival time ranging from several months to 20 years, and its clinical manifestations are complex. There are many factors affecting the prognosis. The International Staging System and Durie-Salmon staging have been established to assess prognosis of the disease, but the accuracy of β2-microglobulin and albumin is controversial. In recent years, new prognostic indicators of MM are being continuously investigated. Studies have shown that renal function in association with the degree of bone destruction, and hypercalcemia, can determine the prognosis of MM and predict overall survival (OS). Moreover, minimal residual disease can also predict OS and progression-free survival in patients with MM. We collected data from MM patients in our hospital, analyzed their clinical efficacy, follow-up results and laboratory examination indicators, which suggested that interleukin-32 can be used as an auxiliary indicator for post-treatment efficacy and prognosis assessment.