Blood Res.  2017 Dec;52(4):293-299. 10.5045/br.2017.52.4.293.

STAT3 expression is associated with poor survival in non-elderly adult patients with newly diagnosed multiple myeloma

Affiliations
  • 1Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Korea. drjejung@chonnam.ac.kr
  • 2Department of Laboratory Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea.

Abstract

BACKGROUND
Signal transducer and activator of transcription 3 (STAT3) is not only a key signaling molecule in the regulation of growth but is also involved in malignant transformation. We investigated the prognostic significance of STAT3 expression in 94 non-elderly adult patients (aged 38 to 65 yr) with newly diagnosed multiple myeloma (MM).
METHODS
Tumor cell-specific phosphotyrosine-STAT3 (PY-STAT3) expression at the time of diagnosis was evaluated with dual immunohistochemical (IHC) staining for PY-STAT3 and CD138.
RESULTS
PY-STAT3 positivity was detected in 10 patients (10.6%), including three who showed strong expression. PY-STAT3-positive patients had higher serum C-reactive protein and calcium levels at diagnosis than did PY-STAT3-negative patients. PY-STAT3 positivity had predictive value for poor progression-free survival (PFS; P=0.001) and overall survival (OS; P=0.003). Among the 60 patients who received frontline autologous stem cell transplantation, PY-STAT3-positive patients had poorer PFS than did PY-STAT3-negative patients (4.2 vs. 19.2 mo, respectively; P=0.013). Multivariate analysis identified PY-STAT3 expression as an independent prognostic factor for PFS (relative risk [RR]=2.706, P=0.014) and OS (RR=3.091, P=0.044).
CONCLUSION
These data show that PY-STAT3 positivity, as determined using dual IHC, is a marker of poor prognosis in non-elderly adult patients with MM.

Keyword

STAT3; Multiple myeloma; Prognosis

MeSH Terms

Adult*
C-Reactive Protein
Calcium
Diagnosis
Disease-Free Survival
Humans
Multiple Myeloma*
Multivariate Analysis
Prognosis
STAT3 Transcription Factor
Stem Cell Transplantation
C-Reactive Protein
Calcium
STAT3 Transcription Factor

Figure

  • Fig. 1 Dual immunohistochemical staining of bone marrow sections obtained at diagnosis shows (A, B) plasma cells positive for CD138 (brown cell membranes) and negative for STAT3 expression and (C, D) plasma cells positive for both CD138 and STAT3 (red nuclei, ×400, ×1,000).

  • Fig. 2 Kaplan–Meier survival curves for progression-free survival and overall survival according to (A, B) PY-STAT3-positivity and (C, D) intensity of PY-STAT3 expression.

  • Fig. 3 Kaplan–Meier survival curves for (A) progression-free survival and (B) overall survival according to PY-STAT3 positivity in patients who underwent frontline autologous stem cell transplantation.


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