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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 β2-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.
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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.
Abbreviations: MM, multiple myeloma; N, sample size.
Table 1.
The Pearson correlation between thrombopoietin and clinical parameters
Table 2.
The analysis of clinical parameters according to the platelet count in patients with elevated thrombopoietin
Table 3.
The analysis of clinical parameters according to the thrombopoietin in blood samples with normal platelet at least 1 yr after the diagnosis of multiple myeloma
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