Unsuppressed serum albumin levels may jeopardize the clinical relevance of the international staging system to patients with light chain myeloma
| Autor: | Hideki Asaoku, Takayuki Saitoh, Mitsuhiro Itagaki, Yoshiaki Kuroda, Toshio Wakayama, Naoko Harada, Tetsuhiro Kasamatsu, Chihiro Shimazaki, Hiroyuki Hata, Takahiro Kobayashi, Shuji Ozaki, Takaaki Miyake, Chiaki Nakaseko, Masahiro Abe, Hiroshi Handa, Tohru Murayama, Takaaki Cho, Tadao Ishida, Tatsuharu Ohno, Eiich Nagura, Naoki Takezako, Kazutaka Sunami, Junya Kuroda, Kazuyuki Shimizu, Nobumasa Inoue, Shotaro Hagiwara, Akiko Negoro, Jun Konishi |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty health care facilities manpower and services Serum albumin Reference range Serum Albumin Human Immunoglobulin light chain Gastroenterology 03 medical and health sciences 0302 clinical medicine health services administration hemic and lymphatic diseases Internal medicine Medicine Humans Clinical significance Stage (cooking) Multiple myeloma Aged Neoplasm Staging Aged 80 and over biology business.industry Albumin Hematology General Medicine Middle Aged medicine.disease Immunoglobulin A Oncology 030220 oncology & carcinogenesis Immunoglobulin G biology.protein Female Immunoglobulin Light Chains Antibody business Multiple Myeloma 030215 immunology |
| Zdroj: | Hematological oncology. 36(5) |
| ISSN: | 1099-1069 |
| Popis: | The international staging system (ISS) is the most commonly used risk-stratification system for patients with multiple myeloma (MM) and is determined by serum albumin and β2-microglobulin levels. In the two determinants, β2-microglobulin levels are frequently observed to be elevated in patients with myeloma, particularly in those with renal impairment. In comparison with patients with intact immunoglobulin myeloma, patients with LC myeloma do not necessarily show decreased levels of serum albumin. The clinical impact of ISS in patients with LCMM, in particular the distinction between ISS I and II, may be complicated due to non-decreased levels of serum albumin in both stages. Accordingly, we have attempted to assess clinical relevance of the ISS in patients with LC myeloma. The clinical data of 1899 patients with MM diagnosed between January 2001 and December 2012 were collected from 38 affiliated hospitals of the Japanese Society of Myeloma. Significant difference was not found between stage I (n = 72) and stage II (n = 92) in LC myeloma patients (n = 307). The mean serum albumin concentration of patients with LC myeloma was within the reference range but higher than that of patients with IgG + IgA myeloma (n = 1501), which complicates the distinction between ISS stage I and II myeloma. Patients with LC myeloma had low frequencies of t(4; 14) and high frequency of elevated lactate dehydrogenase, and despite a relevant amount of missing data in our registry (R-ISS stage I; n = 11, stage II; n = 32, and stage III: n = 18), the information included in the R-ISS scoring system seems to be more accurate than ISS to obtain a reliable risk stratification approach in non-ISS stage III LC myeloma patients. |
| Databáze: | OpenAIRE |
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