| Objective:To explore the difference of serum cholesterol level between multiple myelo ma(MM)patients and healthy people,the correalation between cholesterol level and clinical characteristics,the dynamic change of cholesterol during chemotheraphy according to different treatment response,and the prognostic role of pre-treatment serum cholesterol level in multiple myeloma.Methods:Clinical data including biochemistry of 153 MM patients admitted to our center during 2008 to 2016 and 113 healthy people as control group were collected,follow-up information was ended up to 30,April,2017.Based on these information,we investigated the differences of cholesterol level including total cholesterol(TC),high-density lipoprotein cholesterol(HDL-c)and low-density lipoprotein cholesterol(LDL-c)between the MM group and the control group,the correlation between cholesterol level and clinical characters including albumin and hemoglobulin.Meanwhile the follow-up information of each patient and evaluation before each course of chemotheraphy were analysed to indentify the role of serum cholesterol level in treatment response and prognosisResults:1.In a total of 153 enrolled MM patients,the male/female ratio was 1.19:1,the medium age was 61 yeas old;patients of ISS-Ⅱ and ISS-Ⅲ at diagnosis accounted for 39.2%and 39.9%of the whole group,respectively;there were 65 cases of IgG(45.5%)type MM,54 cases of IgA(35.3%)type MM,22 cases(14.4%)of light chain MM(LCMM),6 cases of IgD(3.9%)type MM,5 cases(3.3%)of nonsecretory MM(NSMM),and one case of IgM(0.6%)type MM.18 patients received autologous stem cell transplantation(ASCT)after induction.In 135 patients who didn’t receive ASCT,65 patients received received Bortizomib based regimen and 70 patients received non-Bortizomib based regimen.2.MM group showed significantly lower serum cholesterol level than the control group(P<0.001),including TC,HDL-c and LDL-c.3.There were significant difference of the pre-treatment serum cholesterol level betweenISS-Ⅰ/Ⅱ group and ISS-Ⅲ group(P<0.05),but no significant difference between different groups of age,sex and bone fracture.4.Cholesterol level including LDL-c,HDL-c,TC were positively correlated with hemoglobin level,platelet count,albumin level,were negatively correlated withβ 2-microglpbulin level,red blood cell distribution(RDW)level,globulin level and phosphate level.LDL-c level and TC level were positively correlated with serum calcium level.There were no correlation between cholesterol level and serum creatinine level,C-reactive protein level,or the percentage of plasma cell in the bone marrow.5.Patients with 1q21 amplification showed lower TC level than patients negative for 1q21 amplification;there were no differences of TC,LDL-c,HDL-c level between IGH rearrangement group and non-IGH rearrangement gro up6.After 2 times of chemotheraphy,the cholesterol level increased significantly in the response group(P<0.001),but in non-response group,the cholesterol level showed no discriminate difference after treatment.7.There were no significant differences of overall survival(OS)and progress-free survival(PFS)between groups of different cholesterol level inpatients who didn’t receive ASCT.Conclusions:MM patients were presented with hypocholesteremia with a significant lower serum cholesterol level compared with healthy people;patients in ISS-Ⅰ/Ⅱshowed significantly higher cholesterol level than patients in ISS-Ⅲ,cholesterol level was positively correlated with hemoglobin level,platelet count,albumin level,were negatively correlated with β2-microglobulin level,red blood cell distribution(RDW)level,globulin level and phosphate level After 2 times of chemotheraphy,the cholesterol level increased significantly when treatment is effective.There was no difference of OS or PFS between groups of different cholesterol level.Our study demonstrated the correlation between serum cholesterol level and disease severity in MM patients,continuous monitor of cholesterol level can be supportive in disease evaluation. |
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