Prognostic value of bone marrow angiogenesis in multiple myeloma.

نویسندگان

  • S V Rajkumar
  • T Leong
  • P C Roche
  • R Fonseca
  • A Dispenzieri
  • M Q Lacy
  • J A Lust
  • T E Witzig
  • R A Kyle
  • M A Gertz
  • P R Greipp
چکیده

We studied the prognostic value of angiogenesis grading and microvessel density estimation in newly diagnosed multiple myeloma. Seventy-five patients with newly diagnosed myeloma, treated on Eastern Cooperative Oncology Protocol E9486 and Intergroup study 0141 (S9321) at the Mayo Clinic, were studied. Bone marrow microvessels were examined using immunohistochemical staining for von Willebrand factor. Determination of microvessel density and angiogenesis grading was done in a blinded manner. There was a strong correlation between microvessel density and the plasma cell labeling index, rho 0.42, P < 0.001. Angiogenesis grade was also significantly associated with the plasma cell labeling index. Fifteen % of patients with low-grade angiogenesis had a high labeling index (>1%). In contrast, 47% of patients with intermediate or high-grade angiogenesis had high labeling indices (P = 0.02). Overall survival was significantly different among those with high-, intermediate-, and low-grade angiogenesis, with median times of 2, 4, and 4.4 years, respectively (P = 0.02). Similarly, patients with microvessel density >50/x400 field had poorer survival compared with those with 50 or fewer microvessels/field, median survival 2.6 versus 5.1 years, respectively (P = 0.004). There was a strong association between angiogenesis grade and microvessel density (P < 0.001). We conclude that bone marrow angiogenesis is a predictor of poor survival in newly diagnosed myeloma. Angiogenesis is correlated with the plasma cell labeling index but not the bone marrow plasma cell percentage. A simple visual grading of angiogenesis is an efficient alternative to microvessel density estimation.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

In vitro Effect of Pomalidomide on Bone Marrow Mononuclear Cells from Multiple Myeloma Patients

Background: Many features of anticancer drugs, including cytotoxicity and/or cytokine induction, are studied using cell lines orhuman blood leukocytes. However, in a disease such as multiple myeloma, most cancerous cells are resided within bone marrowmononuclear cells. In the present study, we investigated the effect of pomalidomide on apoptosis and IL-2 production of bonemarrow mononuclear cel...

متن کامل

Study of Multiple Myeloma Occurrence in Patients With 5%-10% Bone Marrow Plasma Cells: A Case Series Regarding Revised IMWG Diagnostic Criteria

Introduction: Utilizing lower limit of bone marrow plasma cells (BMPCs) is the main existing criterion for diagnosis of multiple myeloma (MM). According to the revised international myeloma working group (IMWG) diagnostic criteria, the value of 10% is agreed among experts as the cutoff level for diagnosis. Symptomatic patients with BMPC above this value are identified as definite cases of MM. H...

متن کامل

Study of Multiple Myeloma Occurrence in Patients With 5%-10% Bone Marrow Plasma Cells: A Case Series Regarding Revised IMWG Diagnostic Criteria

Introduction: Utilizing lower limit of bone marrow plasma cells (BMPCs) is the main existing criterion for diagnosis of multiple myeloma (MM). According to the revised international myeloma working group (IMWG) diagnostic criteria, the value of 10% is agreed among experts as the cutoff level for diagnosis. Symptomatic patients with BMPC above this value are identified as definite cases of MM. H...

متن کامل

Multiple myeloma in a patient with suspected hyperparathyroidism

Multiple myeloma (MM) is a clonal B-lymphocyte neoplasm of terminally differentiated plasma cells. Imaging modalities which allow the recognition of the effects of myeloma cells on the skeletal system have been utilized for a long time. Herein, we represent a patient with generalized osteoporosis and hypercalcemia, who was referred for parathyroid scan, in whom the widespread bone marrow techne...

متن کامل

A Tentative Staging of Multiple Myeloma by Utilizing Respective Coefficients of Prognostic Factors

Introduction: Multiple myeloma is a heterogeneous disease with different survival times among patients. Accurate prediction of prognosis in multiple myeloma is essential, as patients with a shorter survival time may require early bone marrow transplantation (BMT) and more advanced chemotherapy as a part of their first-line treatment. In the present study, a parameter, depicted by ga...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Clinical cancer research : an official journal of the American Association for Cancer Research

دوره 6 8  شماره 

صفحات  -

تاریخ انتشار 2000