3 research outputs found
Serum Levels of Total-RANKL in Multiple Myeloma
Background: Receptor activator of nuclear factor-kappa B ligand (RANKL)
plays a key role in osteoclast activation in myeloma bone disease. The
increased expression of RANKL in the bone marrow microenvironment was
demonstrated in several studies, but there are only rare data on
circulating RANKL levels in patients with multiple myeloma (MM).
Patients and Methods: In the current study, we investigated the clinical
significance of serum RANKL levels, using an enzyme-linked immunosorbent
assay test that detects both free and osteoprotegerin (OPG)-bound RANKL
(total-RANKL, tRANKL) in patients with newly diagnosed MM (n = 93) and
monoclonal gammopathy of undetermined significance (MGUS; n = 20)
compared with healthy controls (n = 20). Results: Circulating serum
tRANKL was significantly elevated in patients with MM compared with
controls (P < .001) or MGUS (P < .001). Furthermore, tRANKL levels were
higher in smoldering MM versus MGUS (P = .031) and in symptomatic versus
smoldering MM (P < .001). Serum tRANKL increased parallel to
International Staging System stages I to III (P = .004) and correlated
with the presence of lytic bone lesions (P < .001). Total-RANKL was a
prognostic factor for overall survival in symptomatic MM (P = .043). A
significantly longer progression-free survival was observed in patients
with a > 50% decrease in tRANKL levels after 3 months of combined
chemotherapy and bisphosphonate treatment. Conclusion: Our study
demonstrates for the first time that serum tRANKL reflects advanced
disease, lytic bone destruction, and poor prognosis in MM