Correlation of C-MYC Protein, MDSC and Th17 Cells with Pathogenesis of Myeloma in Different Clinical Stages / 中国实验血液学杂志

OBJECTIVE@#To investigate the correlation of C-MYC protein with MDSC, Th17 cells and the pathogenesis of myeloma in different clinical stages.@*METHODS@#A total of 65 patients with multiple myeloma treated in our hospital were selected as MM group, and 30 healthy subjects were selected as control group. The positive expression rate of C-MYC protein in bone marrow tissue, and the ratios of peripheral blood MDSC and Th17 cells were compared among the two groups, and the correlation of C-MYC protein, the ratio of MDSC, Th17 cells with onset of myeloma at different clinical stages, the relationship of the expression of C-MYC protein with the ratio of MDSC/Th17 cells and the clinical parameters of MM was analyzed. Also, the diagnostic value of single diagnosis and combined diagnosis was compared.@*RESULTS@#The positive expression rate of C-MYC protein in bone marrow, the ratio of MDSC and Th17 cells in peripheral blood in MM group were significantly higher than those in normal control group(P＜0.05); the positive expression rate of C-MYC protein, MDSC and Th17 cells in patients at ISS stage Ⅰ, Ⅱ and Ⅲ MM showed an increasing trend (r=0.432, r=0.401, r=0.351); the correlation between the ratio of MDSC, Th17 cells and the positive expression rate of C-MYC protein in MM patients was positive (r=0.415, r=0.417); the area under ROC curve (AUC) of combined diagnosis was significantly larger than that of single index diagnosis (C-MYC protein, MDSC cells, Th17 cells)(P＜0.05). There was no correlation between the expression of C-MYC protein, the proportion of MDSC, Th17 cells and sex or age in MM patients (P＞0.05).@*CONCLUSION@#The positive expression rate of C-MYC protein and the proportion of MDSC and Th17 cells in MM patients significantly increase, which positively correlates with clinical ISS stagin.

Efficacy and Safety of Bortezomib in Multiple Myeloma Patients with Hepatitis B: A Multicenter Retrospective Study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The efficacy and safety evidence of bortezomib in multiple myeloma (MM) patients with hepatitis B is vacant. This study aimed to investigate the efficacy and safety of bortezomib in MM patients with hepatitis B in China.</p><p><b>METHODS</b>From 2006 to 2011, 739 newly diagnosed MM patients were screened for serum hepatitis B virus (HBV) biomarkers. HBV-infected patients were followed for HBV reactivation by monitoring of serum alanine transaminase (ALT) and HBV DNA load. The pattern of HBV reactivation in relation to bortezomib was evaluated. Seven hundred thirty-nine MM patients were included in this study.</p><p><b>RESULTS</b>The prevalence of MM patients infected with HBV was 3.4% (n = 25), of which 17 cases were treated with bortezomib. Bortezomib had no significant influence on liver function (ALT before and after treatment: 36.69 ± 8.90 U/L vs. 11.31 ± 2.74 U/L, P = 0.19) and HBV DNA of MM patients with HBV (detectable HBV DNA percentage: 5.9% vs. 11.8%, P = 0.12).</p><p><b>CONCLUSIONS</b>Bortezomib can be used safely and effectively in MM patients with hepatitis B. HBV prophylaxis and surveillance are recommended during the MM treatment.</p>

Clinical significance of serum vascular endothelial growth factor in patients with multiple myeloma / 中国实验血液学杂志

This study was purposed to investigate the relation of serum vascular endothelial growth factor (VEGF) levels with clinical types and therapeutic efficacy of multiple myeloma (MM), and to analyze the significance of VEGF in MM. The levels of serum VEGF were detected by enzyme-linked immunosorbent assay (ELISA) technique in 76 patients with MM. The relationship between the serum VEGF levels with MM patients' age, stages, types, and efficacy were analyzed. The results showed that the patients who were less than 65 years old had higher serum VEGF levels than elder patients, however, the difference between them had no statistical significance (P > 0.05). The VEGF level was the highest in IgG type patients, and then in light chain type, lowest in IgA type, however there were no statistical differences between them (P > 0.05). Patients of DS stage III had higher VEGF level than that of stage II, and there was also no statistical difference (P > 0.25). Patients of ISS stage I had lower VEGF level than that of stage II and III, and it also showed no statistical difference (P > 0.05). After treatment, patients obtained complete remission (CR) or very good partial remission (VGPR) had decrease of serum VEGF level, however, patients obtained less than partial remission (PR) had increase of serum VEGF level. Patients were divided into two groups according serum VEGF level ( ≤ 150 ng/L), patients with high VEGF levels had short overall survival time, there was statistical difference (P = 0.03). It is concluded that the serum VEGF level of MM patients dose not relate with age, clinical stages and M protein types; however, there was a certain association between overall survival and serum VEGF level, and the later may be one of poor prognostic factors.