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Hypercalcemia caused by humoral effects and bone damage indicate poor outcomes in newly diagnosed multiple myeloma patients

BACKGROUND: Hypercalcemia of malignancy (HCM) is a serious metabolic complication, and the highest rates are in multiple myeloma (MM). The cause of hypercalcemia in newly diagnosed multiple myeloma (NDMM) remains unknown. We sought to evaluate the prognostic impact and mechanism of hypercalcemia in...

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Autores principales: Bao, Li, Wang, Yutong, Lu, Minqiu, Chu, Bin, Shi, Lei, Gao, Shan, Fang, Lijuan, Xiang, Qiuqing
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7724491/
https://www.ncbi.nlm.nih.gov/pubmed/33145966
http://dx.doi.org/10.1002/cam4.3594
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author Bao, Li
Wang, Yutong
Lu, Minqiu
Chu, Bin
Shi, Lei
Gao, Shan
Fang, Lijuan
Xiang, Qiuqing
author_facet Bao, Li
Wang, Yutong
Lu, Minqiu
Chu, Bin
Shi, Lei
Gao, Shan
Fang, Lijuan
Xiang, Qiuqing
author_sort Bao, Li
collection PubMed
description BACKGROUND: Hypercalcemia of malignancy (HCM) is a serious metabolic complication, and the highest rates are in multiple myeloma (MM). The cause of hypercalcemia in newly diagnosed multiple myeloma (NDMM) remains unknown. We sought to evaluate the prognostic impact and mechanism of hypercalcemia in patients with symptomatic NDMM. METHODS: We studied all consecutive MM patients who were initially diagnosed and followed up at Beijing Jishuitan Hospital between February 2013 and December 2019; 357 patients were included in the retrospective analysis. RESULTS: A total of 16.8% of MM patients presented with hypercalcemia at the time of MM diagnosis. The presence of hypercalcemia was associated with higher serum levels of β2 microglobulin, creatinine, phosphorus, uric acid, procollagen I N‐terminal peptide, β‐carboxy‐terminal cross‐linking telopeptide of type I collagen and osteocalcin, lower serum levels of hemoglobin, parathyroid hormone (PTH), and advanced ISS and R‐ISS stages. Multivariate analysis showed that serum PTH, hemoglobin, creatinine, and uric acid levels were the main factors affecting hypercalcemia. The presence of hypercalcemia was associated with significantly inferior survival (40 months vs 57 months, p < 0.05) based on univariate analysis, and it remained an independent poor prognostic factor (HR: 1.854, 95% CI: 1.006‐3.415, adjusted p = 0.048) in a multivariate model that included age and R‐ISS stage. CONCLUSION: This study shows that hypercalcemia is associated with poor survival and is caused by manifold factors with humoral effects and local bone destruction.
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spelling pubmed-77244912020-12-13 Hypercalcemia caused by humoral effects and bone damage indicate poor outcomes in newly diagnosed multiple myeloma patients Bao, Li Wang, Yutong Lu, Minqiu Chu, Bin Shi, Lei Gao, Shan Fang, Lijuan Xiang, Qiuqing Cancer Med Clinical Cancer Research BACKGROUND: Hypercalcemia of malignancy (HCM) is a serious metabolic complication, and the highest rates are in multiple myeloma (MM). The cause of hypercalcemia in newly diagnosed multiple myeloma (NDMM) remains unknown. We sought to evaluate the prognostic impact and mechanism of hypercalcemia in patients with symptomatic NDMM. METHODS: We studied all consecutive MM patients who were initially diagnosed and followed up at Beijing Jishuitan Hospital between February 2013 and December 2019; 357 patients were included in the retrospective analysis. RESULTS: A total of 16.8% of MM patients presented with hypercalcemia at the time of MM diagnosis. The presence of hypercalcemia was associated with higher serum levels of β2 microglobulin, creatinine, phosphorus, uric acid, procollagen I N‐terminal peptide, β‐carboxy‐terminal cross‐linking telopeptide of type I collagen and osteocalcin, lower serum levels of hemoglobin, parathyroid hormone (PTH), and advanced ISS and R‐ISS stages. Multivariate analysis showed that serum PTH, hemoglobin, creatinine, and uric acid levels were the main factors affecting hypercalcemia. The presence of hypercalcemia was associated with significantly inferior survival (40 months vs 57 months, p < 0.05) based on univariate analysis, and it remained an independent poor prognostic factor (HR: 1.854, 95% CI: 1.006‐3.415, adjusted p = 0.048) in a multivariate model that included age and R‐ISS stage. CONCLUSION: This study shows that hypercalcemia is associated with poor survival and is caused by manifold factors with humoral effects and local bone destruction. John Wiley and Sons Inc. 2020-11-04 /pmc/articles/PMC7724491/ /pubmed/33145966 http://dx.doi.org/10.1002/cam4.3594 Text en © 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Cancer Research
Bao, Li
Wang, Yutong
Lu, Minqiu
Chu, Bin
Shi, Lei
Gao, Shan
Fang, Lijuan
Xiang, Qiuqing
Hypercalcemia caused by humoral effects and bone damage indicate poor outcomes in newly diagnosed multiple myeloma patients
title Hypercalcemia caused by humoral effects and bone damage indicate poor outcomes in newly diagnosed multiple myeloma patients
title_full Hypercalcemia caused by humoral effects and bone damage indicate poor outcomes in newly diagnosed multiple myeloma patients
title_fullStr Hypercalcemia caused by humoral effects and bone damage indicate poor outcomes in newly diagnosed multiple myeloma patients
title_full_unstemmed Hypercalcemia caused by humoral effects and bone damage indicate poor outcomes in newly diagnosed multiple myeloma patients
title_short Hypercalcemia caused by humoral effects and bone damage indicate poor outcomes in newly diagnosed multiple myeloma patients
title_sort hypercalcemia caused by humoral effects and bone damage indicate poor outcomes in newly diagnosed multiple myeloma patients
topic Clinical Cancer Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7724491/
https://www.ncbi.nlm.nih.gov/pubmed/33145966
http://dx.doi.org/10.1002/cam4.3594
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