The clinical and prognostic significance of erythrocyte sedimentation rate (ESR), serum interleukin-6 (IL-6) and acute phase protein levels in multiple myeloma

Clin Lab Haematol. 2003 Feb;25(1):41-6. doi: 10.1046/j.1365-2257.2003.00492.x.


Interleukin-6 (IL-6) and acute phase proteins are commonly increased in patients with multiple myeloma. Several of these acute phase proteins are believed to predict prognosis and influence survival. We measured interleukin-6 (IL-6), C-reactive protein (CRP), alpha-1-antitrypsin (a1AT), acid alpha-1-glycoprotein (a1AG), haptoglobin (HAP), transferrin (TRF), hemoglobin (Hb), beta-2-microglobulin (beta2M) and erythrocyte sedimentation rate (ESR) in 42 newly diagnosed multiple myeloma patients and 25 normal controls. At the time of blood collection, nine patients were at stage I of disease, 14 at stage II, and 19 at stage III according to the Durie and Salmon myeloma staging system. Mean +/- SD values of IL-6, CRP, a1AT, a1AG, HAP, beta2M, and ESR were significantly higher and Hb significantly lower than those found in the controls. Univariate analysis, using the log-rank test, showed that among the acute phase proteins, serum CRP (P < 0.002), a1AT (P < 0.008) and ESR (P < 0.008) were significantly correlated with survival. However, when a multivariate Cox proportional hazard model was performed, ESR, CRP, a1AT, a1AG and beta2M were identified as independent prognostic factors, while the others were not. We conclude that ESR, a simple and easily performed marker, was found to be an independent prognostic factor for survival in patients with multiple myeloma.

MeSH terms

  • Acute-Phase Proteins / analysis*
  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Sedimentation
  • Case-Control Studies
  • Female
  • Haptoglobins / analysis
  • Humans
  • Interleukin-6 / blood*
  • Male
  • Middle Aged
  • Multiple Myeloma / blood*
  • Multiple Myeloma / diagnosis
  • Multiple Myeloma / mortality
  • Orosomucoid / analysis
  • Prognosis
  • Survival Analysis
  • Transferrin / analysis
  • alpha 1-Antitrypsin / analysis


  • Acute-Phase Proteins
  • Haptoglobins
  • Interleukin-6
  • Orosomucoid
  • Transferrin
  • alpha 1-Antitrypsin