The clinical and prognostic significance of erythrocyte sedimentation rate (ESR), serum interleukin-6 (IL-6) and acute phase protein levels in multiple myeloma

Abstract

Summary Interleukin‐6 (IL‐6) and acute phase proteins are commonly increased in patients with multiple myeloma. Several of these acute phase proteins are believed to predict prognosis and influence survival. We measured interleukin‐6 (IL‐6), C‐reactive protein (CRP), alpha‐1‐antitrypsin (a₁AT), acid alpha‐1‐glycoprotein (a₁AG), haptoglobin (HAP), transferrin (TRF), hemoglobin (Hb), beta‐2‐microglobulin (β₂M) and erythrocyte sedimentation rate (ESR) in 42 newly diagnosed multiple myeloma patients and 25 normal controls. At the time of blood collection, nine patients were at stage I of disease, 14 at stage II, and 19 at stage III according to the Durie and Salmon myeloma staging system. Mean ± SD values of IL‐6, CRP, a₁AT, a₁AG, HAP, β₂M, and ESR were significantly higher and Hb significantly lower than those found in the controls. Univariate analysis, using the log‐rank test, showed that among the acute phase proteins, serum CRP (P < 0.002), a₁AT (P < 0.008) and ESR (P < 0.008) were significantly correlated with survival. However, when a multivariate Cox proportional hazard model was performed, ESR, CRP, a₁AT, a₁AG and β₂M were identified as independent prognostic factors, while the others were not. We conclude that ESR, a simple and easily performed marker, was found to be an independent prognostic factor for survival in patients with multiple myeloma.