The Expression Of Serum GDF15and Its Clinical Significance In Multiple Myeloma Patients

Object:To determine the serum level of the growth differentiation factor15(GDF15) in multiple myeloma (MM) and analyze its level with other clinical parameters, so as to investigate its significance in the clinical treatment and the prognosis assessment for MM.Methods:The MM group patients consisted24newly diagnosed MM patients visited in hematology department of Second Xiangya Hospital from April to November in2012. Peripheral blood specimens of each patients were collected before therapy. And among these patients,4cases were also drew venous blood after3cycles chemotherapy. And20healthy subjects’ blood specimens were also drew as the normal control group. Using the enzyme-linked immunosorbnent assay (ELISA) to measure the serum level of GDF15in both group. All patients’clinical data was collected. And use SPSS17.0to analyze the expression of serum GDF15and its correlations with other data.Results:1. Mean serum GDF15level was significantly higher for MM group (1.37±0.64ng/ml) than for normal control group (0.14±0.06ng/ml, P<0.05).2. Mean serum level of GDF15in the IgG, IgA and light chain MM patients were(1.40±0.64) ng/ml,(1.26±0.69) ng/ml and (1.51±0.74) ng/ml respectively. And there was no significant difference among each type MM (P>0.05).3. The Mean serum GDF15level of MM patients in ISS stage Ⅲ was (1.57±0.48) ng/ml, significantly higher than that of ISS stage (Ⅰ+Ⅱ)(0.77±0.34ng/ml, P<0.05).4. There were not significant positive correlations between the serum GDF15level with serum monoclonal proteins(M protein) level,β2-microglobulin and creatinemia (P<0.05), and significant inverse correlations were found between GDF15level with hemoglobin concentration and platelet count respectively(P<0.05). But serum GDF15level was not associated with patients’age, albumin, lactic dehydrogenase (LDH), C response protein(CRP), calcemia or leukocyte count(P>0.05).5. After3cycles chemotherapy, patients with a>50%reduction of M protein had a significant reduction of GDF15, while for the patients whose M protein did not decrease obviously, their corresponding serum GDF15level increased.Conclusions:1. The serum GDF15level may reflect the tumor burden in MM patients, which increases obviously in MM patients, is related with ISS, positively correlated with serum M protein level,β2-microglobulin level and negatively with hemoglobin concentration and platelet count.2. The serum GDF15level has a close and positive correlation with serum creatinine, which means high level of GDF15may provides information of renal injury.3. The change of serum GDF15level has some relation with the extent of M protein reduction, which means it may be used as a marker for therapy response.4. The serum level of GDF15may not have correlation with MM type.