Serum Mitochondrial Open Reading Frame of the 12S rRNA-c (MOTS-c) Dynamics as a Complementary Marker of Treatment Response in Newly Diagnosed Multiple Myeloma: A Prospective Analysis.

OBJECTIVES: This study evaluated whether serum levels of mitochondrial open reading frame of the 12S rRNA-c (MOTS-c) could provide prognostic insights in patients newly diagnosed with multiple myeloma (MM), particularly in relation to therapeutic responsiveness. METHODS: In a prospective analysis involving 29 MM patients, serum MOTS-c concentrations were measured before and after frontline treatment. Associations between MOTS-c fluctuations and clinical-biochemical variables were systematically explored. RESULTS: Patients who responded to treatment exhibited a substantial post-therapy increase in MOTS-c levels, while refractory cases showed little to no change. Post-treatment MOTS-c values inversely correlated with calcium and neutrophil count changes. Despite limited standalone predictive capacity, MOTS-c dynamics may reflect microenvironmental and metabolic adaptation linked to treatment response. CONCLUSIONS: Changes in serum MOTS-c concentrations following therapy may serve as complementary markers of clinical response in MM. Further validation in larger cohorts is warranted.