Korean J Hematol.  2010 Jun;45(2):115-119. 10.5045/kjh.2010.45.2.115.

Soluble syndecan-1 at diagnosis and during follow up of multiple myeloma: a single institution study

• Kim JM
• Lee JA
• Cho IS
• Ihm CH

• KMID: 2083544
• DOI: http://doi.org/10.5045/kjh.2010.45.2.115

Abstract

BACKGROUND
Syndecan-1 is a heparan sulfate proteoglycan expressed on plasma cells, especially myeloma cells, and can exist in serum as soluble syndecan-1 after shedding from the cell surface. Soluble syndecan-1 has been suggested to promote myeloma cell growth and to be an independent prognostic factor for multiple myeloma. We aimed to evaluate the effect of soluble syndecan-1 levels at the time of diagnosis and during therapy on therapeutic response and prognosis for patients with multiple myeloma.
METHODS
We analyzed soluble syndecan-1 levels in 28 patients with multiple myeloma and 50 normal controls, and compared its levels with Durie-Salmon stage and other markers of myeloma. In addition, we evaluated the therapeutic response and determined the 3-year survival rates of these patients.
RESULTS
We observed that the median soluble syndecan-1 level in myeloma patients was higher than that in the normal controls (P <0.0001), and the soluble syndecan-1 levels in 21 (75%) patients were higher than the cut-off level (162 ng/mL). Soluble syndecan-1 levels correlated with disease stage, percentage of plasma cells in the bone marrow, beta2 microglobulin level, serum M-component concentration, and creatinine level. The baseline levels of soluble syndecan-1 at the time of diagnosis in the patients who responded to chemotherapy were lower than those in the non-responders (P=0.04); however, the baseline level was not a significant predictor of therapeutic response. The 3-year overall survival rate of the patients with high soluble syndecan-1 levels at the time of diagnosis and 6 months after chemotherapy was lower than the corresponding survival rates of the patients with low levels of soluble syndecan-1; however, the overall survival rate was not statistically significant.
CONCLUSION
The use of soluble syndecan-1 has limitations in the diagnosis of multiple myeloma. Soluble syndecan-1 levels correlate with known prognostic factors; however, we could not assess the prognostic value of high levels of soluble syndecan-1 at the time of diagnosis and after chemotherapy.

Keyword

Multiple myeloma; Syndecan-1; Prognosis

MeSH Terms

Bone Marrow
Creatinine
Follow-Up Studies
Heparan Sulfate Proteoglycans
Humans
Multiple Myeloma
Plasma Cells
Prognosis
Survival Rate
Syndecan-1
Creatinine
Heparan Sulfate Proteoglycans
Syndecan-1

Figure

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  Fig. 1 Soluble syndecan-1 levels at diagnosis in 28 patients with multiple myeloma. Horizontal line denotes mean +2 SD (162 ng/mL) of 50 healthy controls (sensitivity, 75% and specificity, 94%).

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  Fig. 2 Kaplan-Meier survival curves for patients classified on the basis of the soluble syndecan-1 levels at 6 months after treatment. The solid line represents patients with low levels of soluble syndecan-1 (≤162 ng/mL), and the dotted line represents patients with high levels of soluble syndecan-1 (>162 ng/mL) (P=0.08).

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