Impact of pre-transplant serum levels of activin A, activin B, IGF-1 and IL-6 on transplant outcomes and survival in patients with multiple myeloma: a prospective study.

IF 3.3 4区医学 Q1 Medicine

European review for medical and pharmacological sciences Pub Date : 2025-04-01 DOI:10.26355/eurrev_202504_37168

E E Yucel, G H Ozsan, A Togay, O C Oztur, F Yuksel, N Yilmaz, A Olgun, I Alacacioglu

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引用次数: 0

Abstract

OBJECTIVE: This prospective study aimed to assess the impact of activin A/B, interleukin 6 (IL-6) and insulin-like growth factor-1 (IGF-1) on end-organ damage, clinical outcomes of high-dose chemotherapy-supported autologous stem cell transplantation (ASCT) and survival rates. MATERIALS AND METHODS: The serum cytokine levels of 78 multiple myeloma (MM) patients scheduled for ASCT at our clinic and 18 healthy volunteers were studied with the Enzyme-Linked ImmunoSorbent Assay (ELISA) method. The association between pre-transplant cytokine levels and clinical data of the patients, the effects of cytokine levels on transplantation results, and the correlation between cytokine concentrations and survival were analyzed. RESULTS: Pre-transplant activin A levels were significantly increased in patients with osteolytic lesions (n=48) compared to those without osteolytic lesions (n=30) (p=0.01). Activin A levels were significantly increased in patients with renal impairment (n=27) compared to those without renal impairment (n=51) (p=0.032). A significant difference was observed between International Staging System (ISS)-3 and ISS-1 stage MM patients according to IL-6 levels (p=0.001). The median follow-up duration was 36.3 months. Progression-free survival (PFS) was 24.8±2.4 months for patients with activin A levels >34.85 pg/ml and 29.7±1.82 months for those with ≤34.85 pg/ml (p=0.044). In univariate analysis, activin A>34.85 pg/ml was identified as an independent prognostic factor for PFS (p=0.012). In the multivariate analysis, activin A levels >34.85 pg/ml (p=0.020) and activin B levels >9.28 pg/ml (p=0.037) were identified as independent prognostic factors for PFS. CONCLUSIONS: Our study demonstrated that elevated activin A levels are correlated with lytic lesions and renal damage. Besides, elevated serum activin A levels before ASCT constitute an independent risk factor for PFS.

Graphical abstract: https://www.europeanreview.org/wp/wp-content/uploads/Graphical-Abstract.png.

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移植前血清激活素A、激活素B、IGF-1和IL-6水平对多发性骨髓瘤患者移植结局和生存的影响：一项前瞻性研究

目的：本前瞻性研究旨在评估激活素A/B、白细胞介素6 （IL-6）和胰岛素样生长因子-1 （IGF-1）对终末器官损伤、高剂量化疗支持的自体干细胞移植（ASCT）临床结局和生存率的影响。材料与方法：采用酶联免疫吸附试验（ELISA）方法对78例在我院行ASCT的多发性骨髓瘤（MM）患者和18名健康志愿者的血清细胞因子水平进行研究。分析移植前细胞因子水平与患者临床资料的关系、细胞因子水平对移植结果的影响、细胞因子浓度与生存的关系。结果：骨溶解病变患者（n=48）移植前激活素A水平显著高于无骨溶解病变患者（n=30）（p=0.01）。肾损害患者（n=27）与无肾损害患者（n=51）相比，激活素A水平显著升高（p=0.032）。国际分期系统(ISS)-3期和ISS-1期MM患者IL-6水平差异有统计学意义（p=0.001）。中位随访时间为36.3个月。激活素A水平为34.85 pg/ml的患者无进展生存期（PFS）为24.8±2.4个月，≤34.85 pg/ml的患者为29.7±1.82个月（p=0.044）。在单因素分析中，激活素A bb0 34.85 pg/ml被确定为PFS的独立预后因素（p=0.012）。在多因素分析中，激活素A水平>34.85 pg/ml （p=0.020）和激活素B水平>9.28 pg/ml （p=0.037）被确定为PFS的独立预后因素。结论：我们的研究表明激活素A水平升高与溶解性病变和肾损害相关。此外，ASCT前血清活化素A水平升高是PFS的独立危险因素。图形摘要：https://www.europeanreview.org/wp/wp-content/uploads/Graphical-Abstract.png。

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来源期刊

European review for medical and pharmacological sciences 医学-药学

CiteScore

5.30

自引率

6.10%

发文量

906

审稿时长

2-4 weeks

期刊介绍： European Review for Medical and Pharmacological Sciences, a fortnightly journal, acts as an information exchange tool on several aspects of medical and pharmacological sciences. It publishes reviews, original articles, and results from original research. The purposes of the Journal are to encourage interdisciplinary discussions and to contribute to the advancement of medicine. European Review for Medical and Pharmacological Sciences includes: -Editorials- Reviews- Original articles- Trials- Brief communications- Case reports (only if of particular interest and accompanied by a short review)