Serum thymidine kinase in monoclonal gammopathies. A prospective study

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Abstract
Between January 1986 and March 1990, the serum levels of thymidine kinase (TK) were evaluated at diagnosis in 97 patients with monoclonal gammopathy of undetermined significance (MGUS) and 149 patients with multiple myeloma (MM) enrolled in a prospective protocol for treatment of MM. At presentation, patients with MGUS had lower TK levels than those with Stage I MM (P < 0.05} and the overall population of those with MM (P < 0.0005). TK levels were increased in advanced stages in comparison with earlier ones (P < 0.01). The TK level was related to survival. With a median follow‐up of 29 months, patients with TK levels greater than 7.0 U/μl had shorter survival times than those with lower levels (medians, 23 and 42 months; P < 0.0001). In a multivariate analysis, TK explained most of the variability of survival (P < 0.0001), the remaining being accounted for by serum creatinine and beta‐2 microglobulin. No changes in TK levels occurred during follow‐up of patients with stable MGUS, whereas TK levels increased in two patients at time of progression to overt MM. In patients with MM, TK levels decreased (P < 0.01) in those who responded to treatment but increased in those having relapses (P < 0.03) and those with progressive disease (P < 0.03). These results indicate that TK has clinical and prognostic relevance in monoclonal gammopathies, and additional investigations are warranted to determine whether it is a useful tool for the clinical evaluation, staging, and follow‐up of patients with MM. Cancer 1992; 69:1368‐1372.

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