Serum YKL-40: a new independent prognostic marker for skeletal complications in patients with multiple myeloma

Abstract

In a time of increasing treatment options for multiple myeloma bone disease, risk factors predicting progression need to be elucidated. This study investigated the value of serum YKL-40, previously shown to be associated with radiographic progression of bone destruction, as a predictor for time to clinical progression, i.e. skeletal-related events (SREs), in 230 newly diagnosed patients with multiple myeloma receiving intravenous bisphosphonates. Serum concentrations of YKL-40 and biochemical bone markers (CTX-MMP, CTX-I, PINP) were measured at diagnosis. Patients were evaluated every third month for SRE and at 9 and 24 months for radiographic progression. Elevated serum YKL-40 was seen in 47% of patients and associated with high-risk disease (International Staging System stage III; p < 0.001), increased bone resorption (serum CTX/MMP; p < 0.001) and early radiographic progression at 9 months (p = 0.01). Serum YKL-40 together with serum CTX-MMP/PINP ratio and World Health Organization status were independent predictors of time to first SRE.

Keywords::

• Multiple myeloma
• skeletal related events
• bisphosphonates
• YKL-40
• CHI3L1

Acknowledgements

The authors would like to thank Tonni Loeve Hansen and Debbie Nadelmann (Department of Medicine, Herlev Hospital, Copenhagen, Denmark) for determination of serum YKL-40.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article at www.informahealthcare.com/lal.

This study was supported by grants from The Faculty of Health Sciences at Copenhagen University, “Direktør Jacob Madsen og hustru Olga Madsens Fond,” “Fabrikant Einar Willumsens Mindelegat,” “Else og Mogens Wedell-Wedellsborgs Fond” and “Direktør Michael Herman Nielsens Mindelegat.”