Serum Growth Differentiation Factor 15 Levels in Newly Diagnosed Multiple Myeloma Patients

Abstract

Background/Aims: Multiple myeloma (MM) is a hematological cancer associated with increased clonal malignant plasma cells. Growth differentiation factor 15 (GDF 15) is a protein that is highly expressed in the bone marrow mesenchymal stem cells of patients with MM. This study investigated whether the clinical stage of the disease, treatment response and survival are affected by pretreatment serum GDF 15 levels. Methods: Serum GDF 15 levels were measured in 35 newly diagnosed MM patients and 27 healthy controls. The correlation between serum GDF 15 levels and various clinical and laboratory parameters was analyzed. Results: The study demonstrated significantly higher levels of GDF 15 in MM patients. There was a negative correlation between GDF 15 levels, hemoglobin and albumin levels, and a positive correlation between GDF 15 levels, CRP, creatinine, β-2-microglobulin and stage. GDF 15 levels were lower in patients who could receive autologous stem cell transplantation compared to other groups, representing a statistically significant difference. However, in the survival analyses, GDF 15 level did not have an impact on survival. Conclusion: High serum levels of GDF 15 may indicate a poor treatment response. Our study supports the prognostic value of GDF 15 in MM.

Growth Differentiation Factor 15 in Multiple Myeloma: A Microenvironment Factor Predictive of Response to Treatment?

“…These data are comparable to those of our previous study [6]. Interestingly, Tarkun et al [1] examined the putative link between GDF15 level and response to treatment and found that the serum GDF15 level was significantly higher in patients with partial response or less than partial response to treatment compared to those with at least very good partial response. However, unlike our previous work, this study failed to demonstrate an impact of the GDF15 level on patient survival.…”

“…In this issue of Acta Haematologica , Tarkun et al [1] report that the level of serum growth differentiation factor 15 (GDF15) is a prognostic factor in multiple myeloma and may predict response to treatment.…”

“…Furthermore, GDF15 conferred resistance to melphalan, bortezomib and lenalidomide in myeloma cell lines, and, in prostate cancer, cells did not respond to docetaxel and mitoxantrone [7]. This chemoprotective bioactivity can be linked to the observation of Tarkun et al [1] who found increased serum GDF15 levels in patients with partial response or less than partial response to treatment. Prospective studies in cohorts of homogeneously treated patients may help to evaluate its predictive value on response to treatment in more detail.…”

“…Because GDF15 has been described to be a p53 target gene [8], an interesting suggestion of Tarkun et al [1] is to specifically determine serum GDF15 levels in these patients. …”

“…Although validation in a prospective study using a larger sample is required, the results of Tarkun et al [1] provide evidence that in myeloma patients the serum GDF15 level could be used as an easy prognostic tool for clinicians. At present, myeloma is the only hematological malignancy with documented GDF15 overexpression.…”