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Myeloma

Incorporation of the bone marker carboxy-terminal telopeptide of type-1 collagen improves prognostic information of the International Staging System in newly diagnosed symptomatic multiple myeloma

Leukemia volume 22, pages 1767–1772 (2008)Cite this article

A Corrigendum to this article was published on 10 September 2008

Abstract

Several prognostic markers, including parameters of tumor burden and cytogenetics, were adopted to identify high-risk patients in multiple myeloma (MM). Recently, the International Staging System (ISS), including β2-microglobulin (β2M) and albumin, was introduced for patients with symptomatic MM. As bone disease is a hallmark of MM, we investigated the prognostic impact of the bone resorption marker carboxy-terminal telopeptide of type-1 collagen (ICTP) in combination with ISS, β2M, albumin, deletion of chromosome 13 and high-dose therapy (HDT) in 100 patients with newly diagnosed symptomatic MM. β2M alone, albumin alone, ISS, HDT, del(13q14) and ICTP were significant prognostic factors for overall survival (OS). In a multivariate analysis, ICTP was the most powerful prognostic factor (log-rank P<0.001, hazard ratio: ninefold increase). ICTP clearly separated two subgroups with a good and a worse prognosis within each of the three ISS stages (ISS I: P=0.027, ISS II: P=0.022, ISS III: P=0.013). Incorporation of ICTP in a combined ICTP-ISS score significantly (P<0.001) separated four risk groups with a 5-year OS rate of 95, 65, 46 and 32%, respectively. These data demonstrate for the first time that the inclusion of the collagen-I degradation product ICTP, as a biomarker of bone resorption, adds to the prognostic value of ISS.

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Authors and Affiliations

  1. Department of Hematology and Oncology, Charité—Universitätsmedizin, Berlin, Germany

    C Jakob, J Sterz, M Mieth, J Rademacher, A Goerke, U Heider, C Fleissner, M Kaiser, I von Metzler & O Sezer

  2. Department of Hematology and Oncology, Universitätsklinikum Ulm, Ulm, Germany

    P Liebisch

  3. Department of Clinical Chemistry, Charité—Universitätsmedizin, Berlin, Germany

    C Müller

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Correspondence to O Sezer.

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Jakob, C., Sterz, J., Liebisch, P. et al. Incorporation of the bone marker carboxy-terminal telopeptide of type-1 collagen improves prognostic information of the International Staging System in newly diagnosed symptomatic multiple myeloma. Leukemia 22, 1767–1772 (2008). https://doi.org/10.1038/leu.2008.159

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