Predictive and prognostic significance of vascular endothelial growth factor (VEGF) and response to VAD protocol of chemotherapy in multiple myeloma patients

Abstract

Angiogenesis plays a crucial role in the pathogenesis of hematological malignancies including multiple myeloma. Objective. Our aim of this study is to assess angiogenesis activators such as vascular endothelial growth factor (VEGF) and its soluble receptor-2(VEGFR-2) in blood plasma of multiple myeloma patients and response to VAD protocol of therapy

Patients and methods:- fifty six patients with multiple myeloma were enrolled in our study, there age range (45─65) with median 53 years old, forty one were males and rest were females, routine hematological and biochemical tests, serum monoclonal protein concentration and/or urinary light chain excretion and β2-microglobulin were performed at the beginning of treatment and three or four months after VAD chemotherapy with serial measurements of vascular endothelial growth factor (VEGF) and its soluble receptor-2(VEGFR-2) in the peripheral blood plasma of patients at diagnosis and after treatment by VAD protocol of chemotherapy . Results There was significant decrement of VEGF and its soluble receptor-2(VEGFR-2) in the plasma of patients who achieved complete or very good partial response (p=0.01 and p=0.04 respectively),a significance association between vascular endothelial growth factor, its soluble receptor and other bad prognostic factors such as stage, high B2 macroglobulin level, ,in multiple myeloma patient ,and when multi analysis was applied a high significant association were detected reflecting independent risk of vascular endothelial growth factor, or its soluble receptor-2, ten myeloma patient (17.8%) showed complete response, while twenty seven (48.2%) patients showed either very good or partial response and rest patient showed no response with tolerated toxicity according to WHO criteria of toxicity, the median time to progression for responders was 22.5 months and 95% confidence interval (CI) was 1.71–3.09.

Conclusion

Vascular endothelial growth factor and its soluble receptor 2 are independent risk factor and decrement of their levels in patients with complete response or very good partial response indicate that the rate of angiogenesis is decreased after successful treatment for multiple myeloma and may open a new future direction in target therapy

Keywords Multiple myeloma, vascular endothelial growth factor, Chemotherapy.

Angiogenesis