Concentrations of soluble tumor necrosis factor receptors, b2-microglobulin, IL-6 and TNF in serum of multiple myeloma patients after chemotherapy and after combined enzyme-therapy

Desser L.,¹ Sakalova A.,² Zavadova E.,¹ Holomanova D.,² Mohr T.¹

1Institute of Tumorbiology/Cancer Research, Department of Applied and Experimental Oncology, University of Vienna, Austria, ²Clinic of Hematology and Transfusiology, University of Bratislava, Slovakia.

7th Interscience World Conference on Inflammation, Antirheumatics, Analgesics, Immunomodulators, Geneva, Switzerland. 19-21 May, 97 
published in Inter. Journal of Immunotherapy 1997, Vol. XIII, No. 3/4, pp. 121-130, ISSN 0255-9625

SO 112 (19-04-2)- (1-08-1)

Summary

The remission time of multiple myeloma (MM) patients after chemotherapy and after enzyme-chemotherapy were compared retrospectively. The remission time was significantly (p<0.0001) longer in stage II enzyme-treated patients. We determined soluble TNF-receptors (sTNF-Rs), p55 and p75; b2-microglobulin (b2M); interleukin-6 (IL-6) and tumor necrosis factor (TNF) in the sera of 198 patients with MM stage I-III. This was done before therapy; after chemotherapy (MOCCA/VMCP); or, after enzyme-chemotherapy (WobeMugos^®, consisting of chymotrypsin, trypsin, papain), and in 67 age-matched healthy volunteers. The serum concentrations of sTNF-Rs and b2M were significantly (p<0.05) elevated in stage II and III patients before therapy; sTNF-Rs and b2M correlate (r = 0.886, p<0.001 for sTNF-R p55 vs. b2M; and r = 0.835 p<0.001 for sTNF-R p75 vs. b2M). The levels of these serum proteins were lower after chemotherapy (stage II p55: p<0.1; p75: p<0.1; stage III p55: p<0.1; p75: p<0.05), and significantly lower after enzyme-chemotherapy (b2M: p<0.1; p55: p<0.05; p75: p<0.05). During the course of the study (17 months), b2M, p55 and p75 levels in 52 MM stage II patients (chemotherapy or enzyme-chemotherapy) were compared. A significant reduction in marker concentration was only observed in MM patients' sera treated with enzyme-chemotherapy (p<0.001). A correlation between the concentration of bioactive IL-6 and immunoreactive IL-6 exists (r = 0.78; p<0.05). No differences in IL-6 concentrations were detected between the treatment groups. The concentration of bioactive TNF was elevated in stage I (all therapies) only, the immunoreactive TNF was elevated in all three stages and treatment groups. Enzyme-chemotherapy prolongs remission times in stage II MM patients and reduces the concentration of progression markers sTNF-R and b2M.