12-05-2005, 04:28 AM
IL-6 is the right choice.
Multiple myeloma is characterized by a triad of marrow plasmacytosis, serum or urine M (monoclonal) protein, and lytic bone lesions. Myeloma is a monoclonal malignancy of the B lymphocyte system, with bone pain the most common symptom. Osteolytic, punched-out bone lesions are characteristic, especially in the skull. Since the process is lytic, alkaline phosphatase is usually not elevated. These osteolytic lesions result from the production of osteoclast-activating factor (OAF) by the myeloma cells. This results in increased serum calcium levels (hypercalcemia). OAF is in fact IL-6, and increased amounts of IL-6 are associated with a worse prognosis because the survival of the myeloma cells is dependent upon IL-6. Myeloma is not associated with lymphadenopathy, but recurrent infections are frequent because of the severe suppression of normal immunoglobulins. In fact, infection is the most common cause of death in these patients and is usually due to encapsulated bacteria. There is no increase in viral infections in these patients because their cell-mediated immunity is normal.
Multiple myeloma is characterized by a triad of marrow plasmacytosis, serum or urine M (monoclonal) protein, and lytic bone lesions. Myeloma is a monoclonal malignancy of the B lymphocyte system, with bone pain the most common symptom. Osteolytic, punched-out bone lesions are characteristic, especially in the skull. Since the process is lytic, alkaline phosphatase is usually not elevated. These osteolytic lesions result from the production of osteoclast-activating factor (OAF) by the myeloma cells. This results in increased serum calcium levels (hypercalcemia). OAF is in fact IL-6, and increased amounts of IL-6 are associated with a worse prognosis because the survival of the myeloma cells is dependent upon IL-6. Myeloma is not associated with lymphadenopathy, but recurrent infections are frequent because of the severe suppression of normal immunoglobulins. In fact, infection is the most common cause of death in these patients and is usually due to encapsulated bacteria. There is no increase in viral infections in these patients because their cell-mediated immunity is normal.