[Level of interleukin-6 (IL-6), soluble interleukin-6 receptors (sIL-6R) and tumor necrosis factor alpha (TNF-alpha) in untreated and progressing multiple myeloma].

36 MM pts in advanced stage, 17 recently diagnozed (group I) and 19 in the progression of the disease (group II) were examined. 10 pts of group I and 12 of group II had renal failure. Levels of II-6, sII-6R and TNF-alpha were measured in pts sera before cytostatic therapy or plasma exchange (PE) and after 4-week therapy. The plasma concentration of II-6, sIl-6R and TNF-alpha before chemotherapy were 47-426 pg/ml, 33-III ng/ml and 19-350 pg/ml respectively and were significantly higher than in healthy control (group III) but no significant changes were observed between group I and group II. Patients with renal failure showed significantly higher II-6 and sIl-6R plasma levels than those with normal renal function. After 4 weeks of chemotherapy plasma concentration of the examined parameters decreased only in those pts of both groups, who later, after 6 mos disclosed a therapeutic response. Median survival time (m-ST) of recently diagnosed MM pts was 38 mos and in those with progression of underlying disease-43 mos. M-ST of 5 pts whose levels of Il-6 > 150 pg/ml, sIl-6R > 55 ng/ml and TNF-alpha-150 pg/ml was only 18 mos, but when only one of them was so much elevated it attained 55 mos. (p = 0.01).