Soluble syndecan-1 (CD138): is it useful as a prognostic factor in Korean patients with multiple myeloma?

which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Editorial Soluble syndecan-1 (CD138): is it useful as a prognostic factor in Korean patients with multiple myeloma? Multiple myeloma (MM) is a malignant hematological neo-plasia of plasma cells. The clinical manifestations of MM are heterogeneous and include monoclonal immunoglobulin production, hypogammaglobulinemia, impaired hematopoi-esis, osteolytic bone disease, hypercalcemia, and renal dy-sfunction. Recently, novel agents such as thalidomide, lena-lidomide, and bortezomib were introduced for the treatment of MM; treatment with these agents can effectively control both relapsed and newly diagnosed diseases and thereby improve survival. Patients with MM show heterogeneous outcomes, which range from a relatively indolent course with a lengthy survival period to a more aggressive disease course with dismal prognosis. Therefore, identification of these subgroups of patients has great clinical significance. Several factors related to the disease or the patient's status have been shown to influence the disease course in MM. The Durie-Salmon staging system was previously used for clinical staging, and currently, the International Staging System (ISS), which uses laboratory factors such as serum albumin and beta-2-microglobulin levels, is commonly applied as a tool for standardized risk assessment [1]. Recently, new genetic risk stratifications have been proposed by several groups. The Mayo stratification, which is based on the results of plasma cell fluorescence in situ hybridization (FISH), metaphase cytogenetics, and plasma cell labeling index (PCLI), is a commonly cited representative system; the developers of this system have framed the mSMART (Mayo Stratification of Myeloma and Risk-Adapted Therapy) consensus guideline as a risk-adapted approach [2]. In the risk stratification, the high-risk group shows del17p, t(4;14), and t(14;16) in FISH, deletion 13 and hypodiploidy in metaphase cytoge-netics, and PCLI ≥3%. Flow cytometric analysis of im-munophenotypic markers such as CD19, CD27, CD28, CD45, CD56, and CD117 has become a useful tool for the diagnosis and monitoring of disease in cases of monoclonal gammo-pathies [3]. Some biological parameters related to myeloma cells, such as hepatocyte growth factor (HGF), vascular en-dothelial growth factor (VEGF), intercellular carboxy-terminal telopeptide of type I collagen (ICTP), procollagen type I N-terminal propeptide (PINP), osteoprotegerin (OPG), and syndecan-1/CD138, have also been reported to play some roles in the diagnosis, staging, and prognosis of MM [4]. Syndecan-1 (CD138) is a transmembrane heparan sul-fate-bearing proteoglycan expressed on the surface of both normal and malignant plasma cells; this molecule regulates the adhesion, migration, and growth …