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High-density lipoprotein (HDL) has an impact on myeloma outcome: Lower HDL associates with worse progression-free survival

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Summary

Background

Multiple myeloma (MM) staging is based on beta‑2 MG, albumin, LDH levels, and the presence of chromosomal abnormalities. We aimed to evaluate the impact of high-density lipoprotein (HDL) on myeloma outcomes.

Materials and methods

This study included 148 individuals; 68 patients diagnosed with MM and 80 age, sex, comorbidity-matched controls. The relationship between HDL and myeloma stage and the association between HDL and progression-free survival (PFS) were analyzed.

Results

Sixty-five percent of patients were male in each group. Mean HDL level was higher in the control group than myeloma group (52.6 ± 15.02 mg/dl versus 33.79 ± 12.71) (p < 0.001). According to ISS, 39 patients (57%) had advanced stage (ISS-III) disease. To assess the optimal cut-point for HDL that makes a difference in PFS, the X‑tile software program was used and in line with the created plots, the myeloma cohort was divided into two groups as HDL < 28 and ≥ 28 mg/dl. Twenty-two patients (32.4%) were in HDL < 28 group. According to the ISS, HDL < 28 group had more advanced disease than the HDL ≥ 28 group (p = 0.008). Twenty-nine patients (42.6%) progressed or died during the follow-up and 15 of these were in the HDL < 28 group. Time to progression was shorter in patients who were in the HDL < 28 group (median, 22 versus 40 months, p = 0.03). There was no statistically significant difference between these groups in terms of overall survival (p = 0.708).

Conclusion

Myeloma patients have lower HDL than controls and HDL < 28 mg/dl associates with advanced-stage disease and shorter PFS. Therefore, HDL can be a surrogate prognostic marker in myeloma.

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Acknowledgements

We thank all of our colleagues and also patients for their assistance.

Funding

This paper was not funded.

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Authors and Affiliations

  1. Division of Hematology, Department of Internal Medicine, Istanbul Medeniyet University, Prof. Dr. Süleyman Yalçın Göztepe City Hospital, Eğitim Mah., Kadıköy, 34722, Istanbul, Turkey

    Işıl Erdoğan Özünal MD

  2. Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey

    Emrah Kılıçaslan, Tayfun Elibol & Erman Öztürk

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  1. Işıl Erdoğan Özünal MD
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  2. Emrah Kılıçaslan
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  3. Tayfun Elibol
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Contributions

IEÖ, EK, TE, and EÖ performed the research and analyzed and interpreted the data. IEÖ and EK created the figures and wrote the manuscript. IEÖ and TE performed the data analyses and EÖ reviewed the manuscript. All authors reviewed the results and approved the final version of the manuscript.

Corresponding author

Correspondence to Işıl Erdoğan Özünal MD.

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Conflict of interest

I. Erdoğan Özünal, E. Kılıçaslan, T. Elibol and E. Öztürk declare that they have no competing interests.

Ethical standards

The study was approved by the local ethics committee of Medeniyet University and approved by the provincial health directorate, Istanbul, per the ethical standards formulated in the Declaration of Helsinki. Informed consent was obtained from all patients.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Erdoğan Özünal, I., Kılıçaslan, E., Elibol, T. et al. High-density lipoprotein (HDL) has an impact on myeloma outcome: Lower HDL associates with worse progression-free survival. Wien Klin Wochenschr (2023). https://doi.org/10.1007/s00508-023-02239-8

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