Soluble CD16 (sCD16), a marker of malignancy in individuals with monoclonal gammopathy of undetermined significance (MGUS)

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There are no well-defined host markers to determine which patients with a diagnosis of monoclonal gammopathy of undetermined significance (MGUS) will progress to multiple myeloma (MM). In this preliminary study we measured plasmatic soluble Fc gamma receptor type III (sFc gamma RIII or sCD16) in 54 individuals with MGUS, 35 patients with multiple myeloma (MM) and 29 healthy controls. We confirmed, through receiver operating characteristics (ROC) curve analysis, that a low level of sCD16 discriminates MM patients from controls. Indeed, for a sCD16 value of 1.3 microgram/ml, the sensitivity, as well as the specificity, of this discrimination were both equal to 83 percent, i.e. 83 percent of MM patients had a plasmatic sCD16 value less than 1.3 microgram/ml compared with only 17 percent of controls. Moreover, ROC curve analysis showed that a low sCD16 level also identifies among MGUS patients a subgroup of patients who rapidly progress towards multiple myeloma: in this comparison, for a sCD16 level of 1.3 microgram/ml, sensitivity and specificity were 70 percent and 79 percent respectively. Therefore a low sCD16 level in MGUS indicated a high likelihood of rapid evolution to MM. In contrast to sCD16, soluble IL-6R did not appear to be discriminant in this study.

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