Predictive Immun Markers for Disease Progression in Multiple Myeloma (MM) and Monoclonal Gammopathy of Undetermined Significance (MGUS).

Multiple Myeloma (MM) and Monoclonal Gammopathy of Undetermined Significance (MGUS), the precursor condition of MM, are plasma cell neoplasms. The evolution of the treatment for MM in recent years has dramatically improved the outcome for these patients. Currently, multidisciplinary studies are conducted to elucidate the etiopathogenesis of the disease and develop specific treatment agents and prognostic markers. To investigate the relationship between immunoexpression of CD138, Pan-Ras, CCL-3, DKK-1 MUM1, and disease progression in cases with MM and MGUS. IHC staining for CD138, Pan-Ras, CCL-3, DKK-1, and MUM-1 was performed on bone marrow biopsy samples from 94 MM and 20 MGUS patients diagnosed between 2011 and 2018. Immunohistochemistry data were examined semi-quantitatively, and the association between IHC, clinical, and biochemical markers utilized for MM and MGUS patient staging were analyzed. Pan-Ras, DKK-1 and MUM-1 staining were significantly higher in MM cases compared to MGUS cases (p = 0.005, 0.001, and 0.001, respectively). The mean CCL-3 expression in patients with MGUS was 23.15 %, while it was 18.68 % in cases with MM (p=0.413). CCL-3 expression was significantly higher in high-risk MGUS cases compared to other groups, according to the Mayo Clinic risk stratification (MCRS) model for MGUS. According to the ISS and R-ISS, CD138 expression was higher in stage 2 and stage 3 patients than in stage 1 patients. Differences in Pan-Ras, MUM-1, DKK-1, and CCL-3 expression between MM and MGUS suggest that these molecules may play a role in the progression of MGUS-MM. CCL-3, an immunohistochemical marker, may be predictive in MGUS progression, while CD138 is associated with more advanced stages of MM.