Serum platelet factor 4 is a promising predictor in newly diagnosed patients with multiple myeloma treated with thalidomide and VAD regimens

Abstract

Objective: Frequent loss of expression of platelet factor 4 (PF4) in multiple myeloma (MM) was revealed in several previous researches. The predictive analysis of serum PF4 level in newly diagnosed MM has not been well elucidated. This study is to assess if serum PF4 could be a prognostic factor in predicting treatment response and survival of MM treated with thalidomide and VAD regimens. Methods: Sera of 122 MM were gained pre-and post-treatment of chemotherapy and oral thalidomide. Serological PF4 measurements were performed by ELISA. Kaplan-Meier method was employed for survival analysis. Log rank test was used significance analysis. Multivariate analysis of overall survival used Cox-regression. Results: Our data showed that the median serum PF4 concentration was negatively associated with MM response and a significant correlation between serum PF4 level and unfavorable clinical features (β2-microglobulin, ISS stage, del17p and creatinine). MM with lower serum PF4 concentration at diagnosis were prone to gain complete remission and very good partial remission after two courses of chemotherapy. Besides del17p, β2-microglobulin, treatment response, the low serum PF4 concentration was an independent variable associated with a poor overall survival by univariate analysis and multivariate analysis. Conclusions: We speculate serum PF4 is a promising response and prognostic factor in newly diagnosed MM treated with thalidomide and VAD regimens.

Cytokine and Chemokine Profile in Patients with Multiple Myeloma Treated with Bortezomib

“…The relationship between the levels of serum cytokines and response to bortezomib-based therapies has not been reported in the literature so far. Higher serum PDGF-BB receptor levels have been observed in melphalan-resistant MM patients than in minor responding patients [49], and a recent study found that median serum platelet factor 4 (PF4) concentration was negatively associated with MM response and that serum PF4 level was significantly correlated with unfavorable clinical features [50]. Lower serum PF4 level was observed…”

Research progress of the chemokine/chemokine receptor axes in the oncobiology of multiple myeloma (MM)

“…CXCL4, called platelet factor 4 (PF-4), can induce MM cell apoptosis by enhancing SOCS3 to regress STAT3, validating its potential predictive value [ 45 ]. A recent study shows that higher PF-4 levels correlate with better outcomes, and higher PF-4 is also observed in healthy individuals [ 46 ]. Differently, CXCL10 can recruit natural killer (NK) cells, cytotoxic T lymphocytes, and macrophages, playing a crucial role in anti-tumor immunity through CXCL9/10/11-CXCR3 axes [ 47 ].…”

“… A lower serum level of PF-4 indicates poor overall survival. - [ 46 ] Dual-effect CCL5 CCR1 CCR3 CCR4 CCR5 CCL5 secreted by MDSC-inducible HMCLs is essential for MDSC induction in the myeloma microenvironment. The CCL5-CCR5 axis can be intervened by immunomodulatory drugs acting on MM cells and PBMCs to prevent MDSC induction.…”