Blood, Vol. 93 No. 12 (June 15), 1999:
pp. 4144-4148
Serum Hyaluronan in Patients With Multiple Myeloma: Correlation With
Survival and Ig Concentration
Inger Marie S. Dahl,
Ingemar Turesson,
Erik Holmberg, and
Karin Lilja for the Nordic Myeloma Study Group
From the Section of Hematology, University Hospital, Tromsø, Norway;
the Department of Medicine, University Hospital, Malmö, Sweden;
the Oncological Centre, Sahlgrenska University Hospital, Gothenburg,
Sweden; and the Department of Medical and Physiological Chemistry,
Biomedical Centre, University of Uppsala, Uppsala, Sweden.
Serum from 386 myeloma patients were analyzed for serum hyaluronan
(HYA) at diagnosis. Median age was 68 years (range, 32 to 87 years).
The distribution of Ig classes was typical (58% IgG, 21% IgA, 1%
IgD, and 20% light chain disease). The patients comprised 58% in
stage III, 33% in stage II, and 9% in stage I. The majority (82%)
had HYA values within an intermediate range (10 to 120 µg/L), 13%
had high values (>120 µg/L), and 5% had abnormally low values (0 to 9 µg/L). For the first time, a patient group with abnormally low
HYA serum values is reported. An inverse correlation between survival
and HYA serum level was found (P = .015). When tested
separately, patients with abnormally low or high HYA values had
significantly shorter median survival (21.1 and 19.7 months,
respectively) than those with an intermediate HYA concentration (32.6 months; P = .005). Patients with abnormally low or high HYA
levels had more advanced disease as judged by staging and biochemical
markers. Interestingly, there was an inverse correlation between the
HYA value and the M-component concentration in serum. Fifty percent of
patients with abnormally low HYA values had IgA myelomas. In
conclusion, the serum concentration of HYA may be of prognostic value
in selected cases of multiple myeloma. Further studies will be
performed to elucidate possible explanations for our findings,
especially those related to the HYA cell surface binding proteins.
