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Prepublished online as a Blood First Edition Paper on April 10, 2003; DOI 10.1182/blood-2003-02-0380. This Article Full Text (PDF) All Versions of this Article: 2003-02-0380v1 102/3/1064    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Terpos, E. Articles by Rahemtulla, A. Search for Related Content PubMed PubMed Citation Articles by Terpos, E. Articles by Rahemtulla, A. Related Collections Related Article in Blood Online Social Bookmarking                   What's this? Submitted February 4, 2003 Accepted April 1, 2003 Soluble receptor activator of nuclear factor B ligand (RANKL)/osteoprotegerin (OPG) ratio predicts survival in multiple myeloma. Proposal for a novel prognostic index Evangelos Terpos*, Richard Szydlo, Jane F Apperley, Evdoxia Hatjiharissi, Marianna Politou, John Meletis, Nora Viniou, Xenophon Yataganas, John M Goldman, and Amin Rahemtulla Department of Hematology, Hammersmith Hospital, Faculty of Medicine Imperial College, London, United Kingdom Department of Hematology, Theagenion Cancer Center, Thessaloniki, Greece First Department of Medicine, University of Athens School of Medicine, Athens, Greece * Corresponding author; email: e.terpos{at}imperial.ac.uk. Interaction between receptor activator of nuclear factor B ligand (RANKL) and RANK/osteoprotegerin (OPG) plays a dominant role in osteoclast activation and possibly in plasma cell survival in multiple myeloma (MM). We measured soluble RANKL (sRANKL), OPG, and bone remodelling markers in 121 newly diagnosed MM patients to evaluate their role in bone disease and survival. Serum levels of sRANKL were elevated in patients with MM and correlated with bone disease. The ratio sRANKL/OPG was also increased and correlated with markers of bone resorption, osteolytic lesions, and markers of disease activity. The ratio sRANKL/OPG, CRP and 2-microglobulin were the only independent prognostic factors predicting survival in multivariate analysis. We have generated a prognostic index based on these factors, which divides our patients into three risk groups. The low-risk group had a 96% probability of survival at five years while the intermediate-risk and the high-risk groups had probabilities of survival of 52% and 0% respectively. Not only do these results confirm for the first time in humans the importance of the sRANKL/OPG in the development of bone disease but they also highlight the role of this pathway in the biology of plasma cell growth as reflected by its influence on survival. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Prognostic staging in myeloma: in search of biology A. K. Stewart Blood 2003 102: 778-779. [Full Text] [PDF] This article has been cited by other articles: M. K. Crook and T. A. Guise RANKL: Targeting Bone and Cancer to Treat Skeletal Complications of Malignancy IBMS BoneKEy, September 1, 2009; 6(9): 323 - 338. [Abstract] [Full Text] [PDF] E. TERPOS, M. KIAGIA, E. M. KARAPANAGIOTOU, A. CHARPIDOU, K. D. DILANA, E. NASOTHIMIOU, K. J. HARRINGTON, A. POLYZOS, and K. N. 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