Elevated Levels of Serum Prolactin in Patients with Advanced Multiple Myeloma

Gadó, Klára; Rimanóczi, É.; Hasitz, Ágnes; Gigler, Gábor; Tóth, Béla; Nagy, György M.; Pálóczi, Katalin; Domján, Gyula

doi:10.1159/000049031

Cited by 12 publications

(7 citation statements)

References 35 publications

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“…In this regard, it has been demonstrated HPRL and PRL-immunostaining in bone marrow cells of patients with multiple myeloma. PRL-immunopositive bone marrow cells disappeared and serum PRL normalized after treatment (Gado et al 2001). This study suggests that B lymphocytes are the source of HPRL in multiple myeloma.…”

Section: Human Studiesmentioning

confidence: 58%

Immune‐Neuroendocrine Interactions and Autoimmune Diseases

Jara

Navarro

Medina

et al. 2006

Journal of Immunology Research

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The relationship between immune-neuroendocrine system is firmly established. The messengers of this connection are hormones, neuropeptides, neurotransmitters and cytokines. The immune-neuroendocrine system have the capacity to synthesize and release these molecules, which, in turn, can stimulate or suppress the activity of immune or neuroendocrine cells by binding to receptors. In fact, hormones, neuropeptides and neurotransmitters participate in innate and adaptive immune response.Autoimmune rheumatic diseases (ARD) are characterized by aberrant production of pro-inflammatory cytokines, which are a potent activator of the HPA axis. In consequence, high levels of pro-inflammatory hormones such as estrogens and prolactin, and low levels of glucocorticoids, an anti-inflammatory hormone, have been described in the active phase of ARD. In addition, high levels of pro-inflammatory hormones and cytokines have also been frequently detected in organ involvement of patients with ARD, suggesting an abnormal local neuroendocrine immune interaction. There is evidence that hormonal changes may appear before the symptomatic phase of the disease. Therefore, it is possible that a pro-inflammatory hormone favors the rupture of tolerance, which is a key feature of autoimmune diseases. The interactions between the immune-neuroendocrine system have a major impact on our understanding of the pathogenic mechanisms, diagnosis and therapy of ARD.

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Section: Human Studiesmentioning

confidence: 58%

Immune‐Neuroendocrine Interactions and Autoimmune Diseases

Jara

Navarro

Medina

et al. 2006

Journal of Immunology Research

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“…In addition, human cell lines of B-lymphoblastoid cells (40) and NHL cells (41) produce PRL. Furthermore, elevated serum PRL levels have been observed in patients with acute myeloid leukemia (20) and in advanced multiple myeloma, where PRL concentrations increased during disease progression (21). If the increased risk of hematopoietic cancers observed in the hyperprolactinemia women is by chance or is to some extent due to a stimulatory effect of PRL remains elusive.…”

Section: Discussionmentioning

confidence: 99%

“…However, the role of PRL in human prostate pathology is not clarified and epidemiological data on PRL and risk of prostate cancer is sparse (15,16). Furthermore, it has been suggested that locally produced PRL could play a role in tumor development in gynecological (17), colorectal (18), tongue (19), and hematopoietic cancer (20,21).…”

Section: Introductionmentioning

confidence: 99%

Cancer risk in hyperprolactinemia patients: a population-based cohort study

Berinder

Akre

Granath

et al. 2011

European Journal of Endocrinology

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Objective: Experimental evidence indicates that prolactin might play a role in tumorigenesis of several human cancers, but data on cancer risk in hyperprolactinemia patients are sparse. The aim of this study was to investigate cancer risk in hyperprolactinemia patients. Design: A population-based matched cohort study in Sweden. Methods: The hyperprolactinemia cohort consisted of patients hospitalized for hyperprolactinemia from 1987 to 1995 identified in the National Patient Register (nZ585) and a hospital cohort of prolactinoma patients at Karolinska University Hospital (nZ384). For each patient, ten matched individuals were identified via the Register of Population. Cancer occurrence was ascertained via the Swedish Cancer Registry. Hazard ratios (HRs) were estimated by Cox proportional hazards regression. Results: Seventy-three malignant tumors were identified in the hyperprolactinemia patients and 660 tumors in the comparison group (HR 1.31; 95% confidence interval (CI): 1.02-1.68), mainly attributed to an increased risk of upper gastrointestinal cancer in both males and females (HR 3.69; 95% CI: 1.70-8.03) and hematopoietic cancer in females (HR 3.51; 95% CI: 1.06-11.6). Twelve breast cancers occurred in the female patients, corresponding to an HR of 1.09 (95% CI: 0.60-1.99). Prostate cancer risk in hyperprolactinemia men was reduced (HR 0.40; 95% CI: 0.16-0.99). Conclusions: An increased overall cancer risk was found in hyperprolactinemia patients, but no increased risk of breast cancer in women and a reduced risk of prostate cancer in men. These findings warrant further investigations and to be confirmed in larger studies but may indicate the importance of an active treatment strategy and follow-up of hyperprolactinemia patients.

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“…In addition, intracytoplasmic PRL has been detected in U266 cells, a human MM cell line [8]. Moreover, MM patients with advanced disease exhibit mildly elevated serum PRL [9]. However, neoplastic plasma cells overexpressing and secreting PRL enough to cause a 100-fold elevation in serum PRL would be unprecedented.…”

Section: Discussionmentioning

confidence: 99%

An unusual collision tumor comprising a prolactinoma and a plasmocytoma originating from the sellar region

et al. 2008

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A 58-year-old previously healthy man presented with diplopia of rapid onset over a few days. Examination demonstrated bilateral sixth and right fourth cranial nerve palsy. MR imaging showed a large sellar mass with significant destruction of the pituitary fossa. Laboratory tests revealed very high serum prolactin (2,483 ng/dl, reference range 3-13 ng/dl). Dopamine agonist therapy was initiated with significant decline in PRL levels; however, nausea, fatigue, and anorexia developed. Within a few weeks the patient developed renal failure and hypercalcemia. Urine protein electrophoresis revealed large free monoclonal kappa peaks while extensive plasmocytosis was evident in bone marrow aspirates. On bone scan numerous lytic lesions were present. A transsphenoidal excisional biopsy was performed which demonstrated two distinct populations of cells, corresponding to a plasma cell tumor and a lactotroph adenoma. Treatment for multiple myeloma was initiated along with radiotherapy for the sellar tumor. Only a few cases of solitary plasmocytomas of the pituitary region have been reported. Few cases of prolactinomas coexisting with other sellar tumors has been described. We discuss in this report possible pathogenic and functional connections between these two tumors. We suggest that in the presence of extensive cranial nerve involvement, atypical imaging findings for a pituitary adenoma and severe hyperprolactinemia, the possibility of a collision tumor should lead the physician to consider excisional tumor biopsy or surgery in addition to dopamine agonist therapy.

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Elevated Levels of Serum Prolactin in Patients with Advanced Multiple Myeloma

Cited by 12 publications

References 35 publications

Immune‐Neuroendocrine Interactions and Autoimmune Diseases

Immune‐Neuroendocrine Interactions and Autoimmune Diseases

Cancer risk in hyperprolactinemia patients: a population-based cohort study

An unusual collision tumor comprising a prolactinoma and a plasmocytoma originating from the sellar region

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