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Blood, Vol. 95 No. 2 (January 15), 2000:
pp. 388-392
Serum syndecan-1: a new independent prognostic marker in multiple
myeloma
Carina Seidel,
Anders Sundan,
Martin Hjorth,
Ingemar Turesson,
Inger Marie S. Dahl,
Niels Abildgaard,
Anders Waage, and
Magne Børset for the Nordic Myeloma Study Group
From the Institute of Cancer Research and Molecular Biology and the
Section of Hematology, University Hospital, Norwegian University of
Science and Technology, Trondheim, Norway; the Department of Medicine,
Lidköping Hospital, Lidköping, Sweden; the Department of
Medicine, Malmö University Hospital, Malmö, Sweden; Section
of Hematology, University Hospital, Tromsø, Norway; and the Department
of Medicine and Hematology, Aarhus University Hospital, Aarhus,
Denmark.
Serum samples drawn at diagnosis from 174 myeloma patients were
analyzed for the presence of the heparin sulfate proteoglycan, syndecan-1. Syndecan-1 was elevated in 79% of patients (median, 643 units/mL) compared with 40 healthy controls (median, 128 units/mL), P < .0001. Serum syndecan-1 correlated with
the following: serum creatinine, secretion of urine M-component over
the course of 24 hours, soluble interleukin-6 (IL-6) receptor,
C-terminal telopeptide of type I collagen,
 2-microglobulin, percentage of plasma cells in the bone
marrow, disease stage, and serum M-component concentration. In order to
evaluate syndecan-1 as a prognostic marker in multiple myeloma, it was
entered into a multivariate Cox regression model. Data from 138 patients were available for this analysis. As a continuous variable,
syndecan-1 was an independent prognostic parameter in addition to serum
2-microglobulin and World Health Organization
performance status. When syndecan-1 was dichotomized by the best cutoff
(66th percentile, 1170 units/mL), the survival difference between the
groups was highly significant: "high" syndecan-1 group had a
median survival of 20 months, and the "low" syndecan-1 group had
a median of 44 months (P < .0001). We conclude that syndecan-1 is a new independent prognostic parameter in multiple myeloma, and its role in prognostic classification systems should be
further investigated.
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