{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:35:34Z","timestamp":1792787734810,"version":"4.5.0"},"reference-count":45,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"publisher","award":["K23NR019296"],"award-info":[{"award-number":["K23NR019296"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"publisher","award":["T32NR009759"],"award-info":[{"award-number":["T32NR009759"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Achievement Rewards for College Scientists (ARCS) Pittsburgh Chapter"},{"name":"K. Leroy Irvis Fellowship at the University of Pittsburgh","id":[{"id":"https:\/\/ror.org\/01an3r305","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Center for Research and Evaluation Pilot\/Feasibility Study Program at the University of Pittsburgh"},{"name":"Supporting Our Scientists Award, funded by The Doris Duke Foundation, in partnership with the University of Pittsburgh and the American Heart Association"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Biological Research For Nursing"],"abstract":"\n At-home administration of oral anticancer medications (OAM) limits interactions with healthcare providers, therefore limiting opportunities for symptom management, posing threats to medication adherence. Individuals diagnosed with multiple myeloma (MM) experience symptoms from both disease- and treatment-related factors. Proteins Beta-2 Microglobulin (B2M) and Lactate Dehydrogenase (LDH) are routinely used in disease monitoring, yet their associations with symptoms and regulation via DNA methylation (DNAm) in individuals with MM have not been investigated. This study explored relationships among LDH and B2M proteins; DNAm of genes\n B2M, LDHA, LDHB<\/jats:italic>\n ; and symptoms in patients prescribed OAMs for MM. This was a 6-month, longitudinal, exploratory analysis. Symptoms were assessed using self-reported measures. Protein levels were extracted from medical records. DNAm of\n B2M, LDHA,<\/jats:italic>\n and\n LDHB<\/jats:italic>\n promoter regions were quantified via pyrosequencing of peripheral blood samples. Linear mixed modeling explored cross-sectional and longitudinal associations. Significant cross-sectional associations were identified between fatigue,\n LDHA<\/jats:italic>\n and\n B2M<\/jats:italic>\n DNAm, and B2M protein (\n p <<\/jats:italic>\n .02); pain and\n LDHA<\/jats:italic>\n and\n B2M<\/jats:italic>\n DNAm (\n p <<\/jats:italic>\n .05); gastrointestinal disturbances and\n LDHA<\/jats:italic>\n DNAm and LDH protein (\n p <<\/jats:italic>\n .05); shortness of breath and\n LDHA<\/jats:italic>\n DNAm (\n p <<\/jats:italic>\n .04); and depression and LDH protein (\n p <<\/jats:italic>\n .04). Longitudinal interaction effects were significant for\n B2M<\/jats:italic>\n DNAm and fatigue (\n p <<\/jats:italic>\n .05),\n LDHA<\/jats:italic>\n and\n B2M<\/jats:italic>\n DNAm and pain (\n p <<\/jats:italic>\n .04), and LDH protein and depression (\n p <<\/jats:italic>\n .04). Prognostic proteins B2M and LDH and their gene-level DNAm patterns were significantly associated with symptoms in individuals taking OAMs for MM. These preliminary findings support further exploration of multi-omics pathways underlying symptoms to inform symptom identification and management strategies.\n <\/jats:p>","DOI":"10.1177\/10998004261496459","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T17:15:38Z","timestamp":1791479738000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring Cross-Sectional and Longitudinal Associations Among DNA Methylation, Prognostic Proteins, and Symptoms in Patients Prescribed Oral Anticancer Medications for Multiple Myeloma"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7056-9430","authenticated-orcid":false,"given":"Abigail","family":"Lustyik","sequence":"first","affiliation":[{"name":"University of Pittsburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1784-6067","authenticated-orcid":false,"given":"Yvette P.","family":"Conley","sequence":"additional","affiliation":[{"name":"University of Pittsburgh"},{"name":"University of Pittsburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine M.","family":"Bender","sequence":"additional","affiliation":[{"name":"University of Pittsburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan M.","family":"Sereika","sequence":"additional","affiliation":[{"name":"University of Pittsburgh"},{"name":"University of Pittsburgh"},{"name":"UPMC Hillman Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhirui","family":"Deng","sequence":"additional","affiliation":[{"name":"University of Pittsburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dianxu","family":"Ren","sequence":"additional","affiliation":[{"name":"University of Pittsburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corrine","family":"Bozich","sequence":"additional","affiliation":[{"name":"University of Pittsburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4095-295X","authenticated-orcid":false,"given":"Sarah M.","family":"Belcher","sequence":"additional","affiliation":[{"name":"University of Pittsburgh"},{"name":"The Ohio State University"},{"name":"The Ohio State University James Comprehensive Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"e_1_3_8_2_1","volume-title":"Multiple myeloma. 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(2015). Treatment-related symptom management in patients with multiple myeloma: A review. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer, 23(5), 1431\u20131445. https:\/\/doi.org\/10.1007\/s00520-014-2552-1","journal-title":"Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer"},{"key":"e_1_3_8_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V114.22.1819.1819"},{"key":"e_1_3_8_14_1","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S106629"},{"key":"e_1_3_8_15_1","volume-title":"StatPearls","author":"Farhana A.","year":"2023","unstructured":"Farhana A., Lappin S. L. (2023). Biochemistry, lactate dehydrogenase. In StatPearls. 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