One of the key enzymes of the pathways resulting in the production of prostaglandins is Cyclooxygenase-2 (COX-2) specifically in the tissue, which is being insulted, and either on the way to transform to or has been transformed to a malignant tissue. Among these cancers, some common ones are: lung, head and neck, ovarian, uterine cervix, colorectum, and breast. Even in the presence of high level of convincing data supporting the role of COX-2 in the progression of cancer, no definitive evidence is available which provides any clue to the relationship between COX-2 and haematological cancers.
Myeloma (MM) is very well described as the deregulation of the cytokine network accompanied by secretion of inflammatory cytokines. A study was carried out to look for the COX-2 deregulation in the pathogenesis of MM.
For this purpose, a sample of 142 specimen form 132 patients with plasma cell dyscrasias were taken and further tested for the expression of the proteins by Western Blot (WB) method. These patients were at different stages of the diseases as far as the advancement or severity was concerned. These specimen samples were taken after the informed consent from the patients were obtained. Clinical features of all the patients were documented. Apart from WB, real time Polymerase Chain Reaction (PCR) were also carried out for some specimen. Along with these, COX-2 immunochemistry as well as separation of plasma cells was also performed. For statistical inferences, descriptive, univariate and multivariate analyses were done by using Cox model.
Apart from the validation and assessment of MM samples and correlation between COX-2 expression and clinical parameters, the prognostic value of COX-2 expression in MM was also determined. It was found that median overall survival (OS) follow up for the study participants was 48 months and the relationship between COX-2 positive and negative was (28 months vs 52 months) and it was significantly different. While Progression Free survival (PFS) was estimated as 18 months for positive and 36 months for negative patients and it was also significantly different. COX-2 was found to be related to MM as a prognostic factor and it opened the venue for treatment options for MM as well as for more research work in the same and related areas to further explore any other associations.
Significant contribution of the study
The research work presented in this article is the first scientific report on the relationship between Cyclooxygenase-2 (COX-2) and Multiple Myeloma (MM). This is indeed an important finding, which adds to the available evidence on two facets: 1) apart from solid tumor, COX-2 has got a relationship with haematological malignancies especially with multiple myeloma where it showed statistically significant association with short progression free period in COX-2 positive patients as compared to COX-2 negative patients (18 vs 36 months; P < .001) and at the same time poor overall survival in COX-2 positive