Multiple Myeloma from the Perspective of Pro- and Anti-Oxidative Parameters: Potential for Diagnostic and/or Follow-Up Purposes?

Abstract

Background: Multiple myeloma is a hematological malignancy characterized by anemia, antibodies causing kidney damage, and damage to multiple organs, which come together to cause morbidity. Although oxidative stress is not a core pathological aspect of multiple myeloma, reactive oxygen species (ROS) and antioxidant balance have been shown to play a role in the disease process and are considered in its management. In the presented study, we aim to assess the reliability of specific oxidant and antioxidant variables as potential biomarkers for multiple myeloma and to determine which of these variables might exhibit higher sensitivity in predicting multiple myeloma. Methods: This case-control study was conducted between March 2023 and August 2023. A total of 30 multiple myeloma patients, newly diagnosed according to the multiple myeloma diagnostic criteria revised by the International Myeloma Study Group in 2014, and a total of 30 volunteers without multiple myeloma were included in this study. Serum glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) and catalase (CAT), and malondialdehyde (MDA) and nitric oxide (NO) levels were measured with the first blood samples taken after inclusion. Results: The groups had similar age (p = 0.623) and sex distribution (p = 1.000). MDA (cut-off: >4.35, p < 0.001), GSH-Px (<59.8, p < 0.001), CAT (<67.2, p < 0.001), SOD (<21.2, p = 0.001), and NO (>38.5, p < 0.001) could significantly detect multiple myeloma. Multivariate logistic regression revealed that increased MDA (p = 0.003) and NO (p = 0.001) levels and decreased GSH-Px (p = 0.001), CAT (p = 0.001), and SOD levels were independently associated with multiple myeloma disease. Conclusions: The presence of increased antioxidant levels and decreased antioxidant levels in patients with multiple myeloma is the clearest indicator of increased oxidative stress. These parameters may help to identify potential therapeutic targets and develop strategies to control disease progression.