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Prepublished online as a Blood First Edition Paper on July 18, 2002; DOI 10.1182/blood-2002-05-1406.
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Blood, 1 December 2002, Vol. 100, No. 12, pp. 3925-3929
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Serum insulinlike growth factor is not elevated in patients with
multiple myeloma but is still a prognostic factor
Therese Standal,
Magne Borset,
Stig Lenhoff,
Finn Wisloff,
Berit Stordal,
Anders Sundan,
Anders Waage, and
Carina Seidel for the Nordic Myeloma Study Group
From the Institute of Cancer Research and Molecular
Biology, Faculty of Medicine, Norwegian University of Science and
Technology, Trondheim, Norway; Department of Haematology,
Lund University Hospital, Lund, Sweden; Department of
Hematology, Ullevål University Hospital, Oslo, Norway;
and Division of Pathology, Institute of Microbiology, Pathology and
Immunology, Karolinska Institute, Huddinge University Hospital,
Stockholm, Sweden.
Insulinlike growth factor 1 (IGF-1) has growth-promoting effects on
myeloma cells in vitro as well as in vivo. In this study, we measured
the concentration of IGF-1 and its major binding protein, IGF- binding
protein 3 (IGFBP-3), in serum from 127 patients with multiple myeloma.
Serum had been drawn at the time of diagnosis, before treatment with
high-dose melphalan. IGFBP-3 in myeloma patients (1.6 ± 0.73
µg/mL; mean ± SD) was significantly decreased compared
to healthy age- and sex-matched controls (2.2 ± 0.42 µg/mL).
However, IGFBP-3 had no prognostic value in this study. The mean IGF-1
level did not differ between myeloma patients (17.8 ± 7.7 nM) and
controls (17.3 ± 5.6 nM). Nevertheless, IGF-1 was a strong indicator
of prognosis. After 80 months of follow-up, myeloma patients with low
levels (< 13 nM) of serum IGF-1 had not reached median survival. In
the patient group with IGF-1 levels above 13 nM, median survival was 62 months (P = .006). These findings support the hypothesis
of a role for IGF-1 in myeloma disease progression.
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