Korean J Lab Med.  2009 Feb;29(1):82-88. 10.3343/kjlm.2009.29.1.82.

The Analysis of Thrombopoietin and Clinical Parameters as a Marker for Disease Progression in Patients with Multiple Myeloma

• Lee JJ
• Kang SY
• Lee WI

• KMID: 1781599
• DOI: http://doi.org/10.3343/kjlm.2009.29.1.82

Abstract

BACKGROUND
Multiple myeloma (MM) causes the suppression of hematopoiesis because of malignant cells in the bone marrow. Thrombopoietin (TPO) is regulated by a feedback mechanism with platelets. Recently, it was suggested that an elevated TPO without thrombocytopenia was associated with impaired hematopoiesis. We evaluated whether TPO levels could be a marker for disease progression in MM.
METHODS
The TPO levels were measured in 70 blood samples from 27 patients (newly/previously-diagnosed patients=13/14). We analyzed the TPO and clinical parameters, WBC, hemoglobin, creatinine, calcium, M-protein, protein, albumin, and beta2-microglobulin. The TPO in 20 healthy controls ranged from 6 to 69 pg/mL.
RESULTS
The TPO levels were significantly higher in MM patients with thrombocytopenia than in patients without thrombocytopenia and the healthy controls (median TPO: 293.0 pg/mL vs 59.6 pg/mL and 35.6 pg/mL, P<0.0001). There was a negative correlation between the TPO levels and the blood cells, i.e., leukocytes (r=-0.293), hemoglobin (r=-0.378) and platelets (r=-0.508) (P<0.05). Elevated TPO were found in association with normal platelet counts (N=20). Among the samples without thrombocytopenia, especially one year after the diagnosis, the hemoglobin (10.3 vs 12.9 g/dL, P=0.025) and albumin (3.3 vs 4.0 g/dL, P=0.085) were lower and the M-protein and protein tended to be higher in patients with elevated TPO compared to those with normal TPO.
CONCLUSIONS
Serum TPO was elevated with thrombocytopenia and related to impaired hematopoiesis. The elevated TPO without thrombocytopenia might be considered as impaired hematopoiesis and a marker for disease progression in patients with MM.

Keyword

Thrombopoietin; Multiple myeloma; Hematopoiesis; Platelet

MeSH Terms

Aged
Biological Markers/blood
Blood Cell Count
Clinical Chemistry Tests
Disease Progression
Female
Hematopoiesis
Humans
Male
Middle Aged
Multiple Myeloma/*diagnosis/etiology
Platelet Count
Prognosis
Retrospective Studies
Thrombocytopenia/*blood/complications
Thrombopoietin/*blood

Figure

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  Fig. 1. The serum thrombopoietin level of healthy control and patients with multiple myeloma. The serum thrombopoietin level was not only significantly different among three groups (P<0.0001) by ANOVA but also between multiple myeloma with normal platelet and multiple myeloma with decreased platelet (P<0.001) by Mann-Whitney test.

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