In a recently published study, Saidi et al. showed that elevated levels of CHI3L1 mRNA, encoding the secreted glycoprotein YKL-40, are associated with poor survival in glioblastoma, probably by promoting angiogenesis. 1 A role for YKL-40 in angiogenesis is supported by a few in vitro studies on the porcine YKL-40 analogue, gp38k, showing 84% sequence homology with human Gp38k is secreted by differentiating vascular smooth muscle cells 2 and besides modulating adhesion and migration of these cells, 3 gp38k stimulates both directional migration of human umbilical vein endothelial cells (HUVEC), at a level comparable to that achieved with the endothelial cell chemoattractant basic fibroblast growth factor (bFGF), 4 and reorganisation of HUVEC with the formation of branching tubules. 4 Angiogenesis plays a central role in the pathogenesis and progression of solid tumours. In recent years, there has been growing evidence that bone marrow (BM) angiogenesis exerts a similar role in certain hematological malignancies, including multiple myeloma (MM). 5 As seen in glioblastoma and several other types of solid tumours, 6,7 a subgroup of patients with MM display elevated levels of serum YKL-40 associated with a more aggressive course of the disease, 8 but a possible role for YKL-40 in the biology of MM remains to be established. Inspired by the study from Saidi et al., we have investigated the association between serum YKL-40 and the degree of BM angiogenesis in 45 patients with newly diagnosed MM. Patient characteristics included age (median 67 years; range, 44-83 years), gender (49% male; 51% female), M-protein isotype (69% IgG; 20% IgA; 9% light chains only; 2% nonsecretory), and stage according to the International Staging System ISS (19% stage I; 49% stage II; 32% stage III). Thirty-six patients received conventional treatment, and 9 patients received high-dose chemotherapy followed by autologous stem cell transplantation. Serum concentrations of YKL-40 were determined in duplicates using a sandwich-type enzyme-linked immunosorbent assay (ELISA) (Quidel 1 , Santa Clara, CA). 8 BM angiogenesis was estimated as microvessel density (MVD), as previously described. 9 The angiogenic cytokines bFGF, hepatocyte growth factor (HGF) and interleukin-6 (IL-6) were measured in serum, also as previously described. 9 The study was approved by the local ethical committee and performed in accordance with the Helsinki II declaration.The median serum YKL-40 for all 45 MM patients was 123 lg/l (range, 26-1,828 lg/l). Using the upper limit in the agespecific 90% reference range for healthy adults, 8 the study population was divided into one group of 21 MM patients with a normal serum YKL-40, i.e., below the limit, and one group of 24 MM patients with an elevated serum YKL-40, i.e., above the limit. In this study population, the serum YKL-40 level lacked association with the degree of BM angiogenesis estimated as MVD (Fig. 1a). The median MVD was 109 vessel profiles per mm 2 (range, 15-238 vessel profiles per mm 2 ). The degree of BM angi...