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Prepublished online as a Blood First Edition Paper on July 18, 2002; DOI 10.1182/blood-2002-05-1406.
Submitted May 14, 2002
Accepted July 8, 2002
Serum insulin-like growth factor is not elevated in patients with multiple myeloma but is still a prognostic factor
Therese Standal*, Magne Borset, Stig Lenhoff, Finn Wisloff, Berit Stordal, Anders Sundan, Anders Waage, and Carina Seidel
Institute of Cancer Research and Molecular Biology, Norwegian University of Science and Technology, Trondheim, Norway
Department of Haematology, Lund University Hospital, Lund, Sweden
Department of Hematology, Ullevaal University Hospital, Oslo, Norway
Division of Pathology, Institute of Microbiology, Pathology and Immunology, Huddinge University Hospital, Stockholm, Sweden
* Corresponding author; email: therese.standal{at}medisin.ntnu.no.
IGF-1 has growth-promoting effects on myeloma cells in vitro as well as in vivo. In this study we measured the concentration of IGF-1 and its major binding protein, IGF binding protein 3 (IGFBP-3), in serum from 127 patients with multiple myeloma. Serum had been drawn at the time of diagnosis, before treatment with high-dose melphalan. IGFBP-3 in myeloma patients (1.6 µg/ml±0.73 mean±SD) was significantly decreased compared to healthy age- and sex-matched controls (2.2 µg/ml±0.42). However, IGFBP-3 had no prognostic value in this study. Mean IGF-1 did not differ between myeloma patients (17.8±7.7nmol/L) and controls (17.3±5.6 nmol/L). Nevertheless, IGF-1 was a strong indicator of prognosis. After 80 months follow-up, myeloma patients with low levels (<13 nmol/L) of serum IGF-1 had not reached median survival. In the patient group with IGF-1 levels above 13 nmol/L median survival was 62 months (p=0.006). These findings support the hypothesis of a role for IGF-1 in myeloma disease progression.
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