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Geduk¹ A, Oztas B, Eryılmaz BH, Demirsoy ET, Menguc MU, Unal S, Mersin S, Polat MG, Aygun K, Yenihayat EM, Albayrak H, Erol HA, Balcı S, Mehtap¹ O, Tarkun¹ P, Hacihanefioglu¹ A. Effects of AGEs, sRAGE and HMGB1 on Clinical Outcomes in Multiple Myeloma. Indian J Hematol Blood Transfus 2023; 39:220-227. [PMID: 37006982 PMCID: PMC10064350 DOI: 10.1007/s12288-022-01574-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 08/31/2022] [Indexed: 11/07/2022] Open
Abstract
Purpose The receptor for advanced glycation end products (RAGE) upregulated during the onset and progression of cancer and bone-related pathologies. In this study, we aimed to investigate the role of serum advanced glycation end products (AGEs), soluble RAGE (sRAGE) and high mobility group box 1 (HMGB1), in multiple myeloma (MM). Methods AGEs, sRAGE and HMGB1 concentrations of 54 newly diagnosed MM patients and 30 healthy volunteers were measured by ELISA. The estimations were done only once at diagnosis. The medical records of the patients were evaluated. Results There was no significant difference between the AGEs and sRAGE levels between the patient and control groups (p = 0.273, p = 0.313). In ROC analysis, a HMGB1 cutoff value of > 9170 pg/ml accurately discriminated MM patients (AUC = 0.672, 95% CI 0.561-0.77, p = 0.0034). AGEs level was found to be significantly higher in early-stage disease and HMGB1 in advanced disease (p = 0.022, p = 0.026). High HMGB1 levels were detected in patients whose with better first-line treatment response (p = 0.019). At 36 months, 54% of patients with low AGE were alive, compared to 79% of patients with high AGE (p = 0.055). Patients with high HMGB1 levels tended to have a longer PFS (median 43 mo [95% CI; 20.68-65.31] ) compared to patients with low HMGB1 levels (median 25 mo [95% CI; 12.39-37.6], p = 0.054). Conclusion In this study, a significant elevation of serum HMGB1 level was found in MM patients. In addition, the positive effects of RAGE ligands on treatment response and prognosis were determined.
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Affiliation(s)
- Ayfer Geduk¹
- Department of Hematology, Medical Faculty, Kocaeli University, 11.km, 41380 Umuttepe, Kocaeli, Turkey
| | - Berrin Oztas
- Department of Biochemistry, Medical Faculty, Kocaeli University, Kocaeli, Turkey
| | - Baldan Huri Eryılmaz
- Department of İnternal Medicine, Medical Faculty, Kocaeli University, Kocaeli, Turkey
| | - Esra Terzi Demirsoy
- Department of Hematology, Derince Training and Research Hospital, Health Sciences University, Kocaeli, Turkey
| | - Meral U. Menguc
- Department of Hematology, Medical Faculty, Bolu Abant İzzet Baysal University, Bolu, Turkey
| | - Serkan Unal
- Department of Hematology, Kastamonu Training and Research Hospital, Kastamonu, Turkey
| | - Sinan Mersin
- Department of Hematology, Medical Faculty, Kocaeli University, 11.km, 41380 Umuttepe, Kocaeli, Turkey
| | - Merve Gokcen Polat
- Department of Hematology, Medical Faculty, Kocaeli University, 11.km, 41380 Umuttepe, Kocaeli, Turkey
| | - Kemal Aygun
- Department of Hematology, Medical Faculty, Kocaeli University, 11.km, 41380 Umuttepe, Kocaeli, Turkey
| | - Emel Merve Yenihayat
- Department of Hematology, Medical Faculty, Kocaeli University, 11.km, 41380 Umuttepe, Kocaeli, Turkey
| | - Hayrunnisa Albayrak
- Department of Hematology, Medical Faculty, Kocaeli University, 11.km, 41380 Umuttepe, Kocaeli, Turkey
| | - Hasim Atakan Erol
- Department of Hematology, Medical Faculty, Kocaeli University, 11.km, 41380 Umuttepe, Kocaeli, Turkey
| | - Sibel Balcı
- Department of Biostatistics and Medical Informatics, Medical Faculty, Kocaeli University, Kocaeli, Turkey
| | - Ozgur Mehtap¹
- Department of Hematology, Medical Faculty, Kocaeli University, 11.km, 41380 Umuttepe, Kocaeli, Turkey
| | - Pinar Tarkun¹
- Department of Hematology, Medical Faculty, Kocaeli University, 11.km, 41380 Umuttepe, Kocaeli, Turkey
| | - Abdullah Hacihanefioglu¹
- Department of Hematology, Medical Faculty, Kocaeli University, 11.km, 41380 Umuttepe, Kocaeli, Turkey
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Baksh M, Jiang L, Bhatia U, Alegria V, Sher T, Roy V, Chanan‐Khan A, Ailawadhi S, Parrondo RD. Management of lytic bone disease in lymphoplasmacytic lymphoma: A case report and review of the literature. Clin Case Rep 2021; 9:e05181. [PMID: 34934497 PMCID: PMC8650751 DOI: 10.1002/ccr3.5181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/17/2021] [Accepted: 11/21/2021] [Indexed: 12/22/2022] Open
Abstract
Waldenström macroglobulinemia (WM)/lymphoplasmacytic lymphoma (LPL) is often differentiated from myeloma based on the presence of lytic bone lesions (LBL). However, WM/LPL can present with LBL, and management is poorly understood. We describe a case of an 81-year-old woman with LPL who presented with LBL and was successfully treated with chemoimmunotherapy.
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Affiliation(s)
- Mizba Baksh
- Division of Hematology‐OncologyMayo ClinicJacksonvilleFloridaUSA
| | - Liuyan Jiang
- Department of PathologyMayo ClinicJacksonvilleFloridaUSA
| | - Unnati Bhatia
- Division of Hematology‐OncologyMayo ClinicJacksonvilleFloridaUSA
| | - Victoria Alegria
- Division of Hematology‐OncologyMayo ClinicJacksonvilleFloridaUSA
| | - Taimur Sher
- Division of Hematology‐OncologyMayo ClinicJacksonvilleFloridaUSA
| | - Vivek Roy
- Division of Hematology‐OncologyMayo ClinicJacksonvilleFloridaUSA
| | - Asher Chanan‐Khan
- Division of Hematology‐OncologyMayo ClinicJacksonvilleFloridaUSA
- Department of Cancer BiologyMayo ClinicJacksonvilleFloridaUSA
- Hematology‐OncologySt. Vincent's RiversideJacksonvilleFloridaUSA
| | - Sikander Ailawadhi
- Division of Hematology‐OncologyMayo ClinicJacksonvilleFloridaUSA
- Department of Cancer BiologyMayo ClinicJacksonvilleFloridaUSA
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Gupta M, Singhal L, Kumar A. Hyperparathyroidism Mimicking Metastatic Bone Disease: A Case Report and Review of Literature. J Adolesc Young Adult Oncol 2018; 7:400-403. [PMID: 29446693 DOI: 10.1089/jayao.2017.0114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Multiple osteolytic lesions are usually associated with metastatic involvement of the bone; however, metabolic bone diseases should also be included in the differential diagnosis. In this study, we describe a case of primary hyperparathyroidism (PHPT) with multiple osteolytic lesions that was diagnosed initially as having metastatic bone involvement. The laboratory results showed hypercalcemia and raised alkaline phosphatase along with fibrosis in the bone marrow biopsy with no increase in tumor markers and normal serum protein electrophoresis. The parathyroid hormone levels were high, which pointed toward a diagnosis of PHPT. Sestamibi scan revealed uptake at the level of the left inferior pole of the thyroid gland, which was suggestive of parathyroid adenoma. The possibility of hyperparathyroidism should be kept in mind when a patient presents with multiple osteolytic lesions and hypercalcemia.
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Affiliation(s)
- Monica Gupta
- 1 Department of Oncopathology, Delhi State Cancer Institute , Delhi, India
| | - Lalita Singhal
- 2 Department of Clinical Oncology, Delhi State Cancer Institute , Delhi, India
| | - Akshay Kumar
- 3 Department of Nuclear Medicine, Delhi State Cancer Institute , Delhi, India
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Ippolito D, Talei Franzesi C, Spiga S, Besostri V, Pezzati S, Rossini F, Sironi S. Diagnostic value of whole-body ultra-low dose computed tomography in comparison with spinal magnetic resonance imaging in the assessment of disease in multiple myeloma. Br J Haematol 2017; 177:395-403. [PMID: 28233900 DOI: 10.1111/bjh.14545] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 11/23/2016] [Indexed: 02/05/2023]
Abstract
This study compared the diagnostic value of Whole-Body Ultra Low-Dose computed tomography (WBULDCT) with that of Spinal Magnetic Resonance Imaging (SMRI) in identification of spinal bone marrow involvement in patients with Multiple Myeloma (MM). Thirty-five patients with histologically proven MM underwent WBULDCT and dedicated SMRI. Unenhanced WBULDCT was performed on a 256-slice scanner, with 120 kV and 40 mAs. SMRI was performed on a 1·5T magnet, with T1-turbo spin echo and T2-short tau inversion recovery sequences on sagittal plane. WBULDCT was compared with SMRI in terms of lesion detection, pattern and bone marrow involvement. The overall concordance between WBULDCT and SMRI in lesion detection was 76·7%, detecting (25/35) or excluding (8/35) involvement of the axial skeleton, while in 2/35 patients WBULDCT and SMRI were discordant in terms of axial skeleton involvement. The concordance in spinal distribution of lesions was 61·6% on cervical, 71·5% on dorsal, 86·4% on lumbar and 94·4% on sacral, while for the pattern of disease, it was 56·1% for the focal and 88·7% for the combined pattern. Cohen's kappa index was 0·85 (P < 0·001) assessing an excellent agreement. WBULDCT represents a useful diagnostic tool in the detection of spinal involvement of MM patients, offering detailed information about extra-axial involvement, which could be potentially missed with dedicated SMRI.
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Affiliation(s)
- Davide Ippolito
- Department of Diagnostic Radiology, San Gerardo Hospital, Monza, MB, Italy
- School of Medicine, University of Milano-Bicocca, Monza, MB, Italy
| | - Cammillo Talei Franzesi
- Department of Diagnostic Radiology, San Gerardo Hospital, Monza, MB, Italy
- School of Medicine, University of Milano-Bicocca, Monza, MB, Italy
| | - Sara Spiga
- Department of Diagnostic Radiology, San Gerardo Hospital, Monza, MB, Italy
- School of Medicine, University of Milano-Bicocca, Monza, MB, Italy
| | - Valeria Besostri
- Department of Diagnostic Radiology, San Gerardo Hospital, Monza, MB, Italy
- School of Medicine, University of Milano-Bicocca, Monza, MB, Italy
| | - Sara Pezzati
- Department of Haematology, San Gerardo Hospital, Monza, MB, Italy
| | - Fausto Rossini
- Department of Haematology, San Gerardo Hospital, Monza, MB, Italy
| | - Sandro Sironi
- School of Medicine, University of Milano-Bicocca, Monza, MB, Italy
- Department of Diagnostic Radiology, Papa Giovanni XXIII Hospital, Bergamo, Italy
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Horger M, Ditt H, Liao S, Weisel K, Fritz J, Thaiss WM, Kaufmann S, Nikolaou K, Kloth C. Automated "Bone Subtraction" Image Analysis Software Package for Improved and Faster CT Monitoring of Longitudinal Spine Involvement in Patients with Multiple Myeloma. Acad Radiol 2017; 24:623-632. [PMID: 28256439 DOI: 10.1016/j.acra.2016.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 12/18/2016] [Indexed: 01/16/2023]
Abstract
RATIONALE AND OBJECTIVES The study aimed to assess the diagnostic benefit of a novel computed tomography (CT) post-processing software generating subtraction maps of longitudinal non-enhanced CT examinations for monitoring the course of myeloma bone disease in the spine. MATERIALS AND METHODS The local institutional review board approved the retrospective data evaluation. Included were 82 consecutive myeloma patients (46 male; mean age, 65.08 ± 9.76) who underwent 188 repeated whole-body reduced-dose Multislice Detector Computed Tomography (MDCT) at our institution between December 2013 and January 2016. Lytic bone lesions were categorized as new or enlarging versus stable. Bone subtraction maps were read in combination with corresponding 1-mm source images comparing results to those of standard image reading of 5-mm axial and 2-mm multiplanar reformat reconstructions (MPR) scans and hematologic markers, and classified as either progressive disease (PD) or stable disease (SD or remission). The standard of reference was 1-mm axial CT image reading + hematologic response both confirmed at follow-up. For statistical purposes, we subgrouped the hematologic response categories similarly to those applied for CT imaging (progression vs stable/response). RESULTS According to the standard of reference, 16 patients experienced PD and 66 SD at follow-up. Th sensitivity, specificity, and accuracy for axial 5 mm + 2 mm MPR image versus bone subtraction maps in a "lesion-by-lesion" reading were 97.6%, 92.3%, and 97.2% versus 97.8%, 96.7%, and 97.7%, respectively. The use of bone subtraction maps resulted in a change of response classification in 9.7% of the patients (n = 8) versus 5 mm + 2 mm MPR image reading from SD to PD. Bone sclerosis lesions were detected in 52 out of 82 patients (63.4%). The reading time was significantly lower with the software bone subtraction compared to standard reading (P < 0.01) and 1-mm image reading (P < 0.001). CONCLUSION Accuracy of bone subtraction maps reading for monitoring multiple myeloma is slightly increased over that of conventional axial + MPR image reading and significantly speeds up the reading time.
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Nierste BA, Glackin CA, Kirshner J. Dkk-1 and IL-7 in plasma of patients with multiple myeloma prevent differentiation of mesenchymal stem cells into osteoblasts. Am J Blood Res 2014; 4:73-85. [PMID: 25755907 PMCID: PMC4348795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 12/15/2014] [Indexed: 06/04/2023]
Abstract
Bone disease is the leading cause of morbidity associated with multiple myeloma (MM). Lytic bone lesions have been detected in 90% of patients diagnosed with MM and present a great therapeutic challenge. After the removal of the tumor burden, the bone lesions persist and the bone remodeling homeostasis is not restored even in patients in clinical remission. To determine whether systemic factors generated by malignant MM cells can skew the osteoblast (OB) differentiation program of normal mesenchymal stem cells (MSCs), we generated an immortalized bone marrow MSC line (hTERT-MSC). The hTERT-MSCs were exposed to plasma from healthy donors and patients with MM. Cells grown in media supplemented with plasma from MM patients failed to differentiate into OBs, while the hTERT-MSCs grown in the presence of normal human plasma generated OB clusters that mineralized calcium, expressed Runx2, and were positive for alkaline phosphatase, fibronectin, collagen I, osteocalcin, and osteopontin. Blocking Dickkopf-1 (Dkk-1) and interleukin-7 (IL-7) in MM plasma restored proper OB differentiation of hTERT-MSCs. Finally, we show that hTERT-MSCs cultured in the presence of MM plasma adopt a cancer-associated stroma phenotype. Thus, we show, that systemic factors present in the plasma of patients with MM affect the behavior of non-malignant MSCs and contribute to the sustained bone disease reported in MM.
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Affiliation(s)
- Brittany A Nierste
- Department of Biological Sciences, Purdue UniversityWest Lafayette, IN, USA
| | - Carlotta A Glackin
- Division of Neurosciences, Beckman Research Institute, City of Hope National Medical CenterDuarte, CA, USA
| | - Julia Kirshner
- Department of Biological Sciences, Purdue UniversityWest Lafayette, IN, USA
- Current affiliation: Ixchel ScientificUSA
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