Abstract
Increased angiogenesis has been found to be an adverse prognostic factor in solid tumors but evidences show that angiogenesis also plays an important role in hematological malignancies including multiple myeloma (MM). In this report we studied the various angiogenesis parameters like microvessel density (MVD) and total vascular area (TVA), on bone marrow biopsies in 50 newly diagnosed cases of MM. The aim was to study bone marrow angiogenesis in MM using light microscopy (MVD-A) and computerized image analyzer (MVD-B and TVA) and correlate it with clinical features, laboratory findings, histological features, and response to treatment on follow-up. Bone marrow biopsies of test cases (n = 50) were immunohistochemically stained with CD34 for visualization of microvessels. MVD-A (range 8–80; mean 50.4; SD 17.5), MVD-B (5.2–33.2; mean 16.3; SD 5.1), and TVA in percentage (range 0.42–7.20; mean 2.8; SD 1.5) were measured. Ten age- and sex-matched controls were studied and their parameters were taken as grade I. There was a significant correlation between these angiogenesis parameters (MVD-A vs MVD-B, Pearson’s correlation coefficient (pcc) = 0.724; MVD-A vs TVA, pcc = 0.370; MVD-B vs TVA, pcc = 0.406). The angiogenesis was significantly higher in cases as compared to controls. Patients with residual disease had a higher MVD as compared to the complete responders. High tumor burden and diffuse pattern of infiltration were also associated with grade III MVD and TVA. Hence, it can be concluded that angiogenesis correlates with other histological features associated with prognosis and is also a good predictor for complete response in patients with multiple myeloma.
Similar content being viewed by others
References
Carmeliet P (2003) Angiogenes in health and disease. Nat Med 9:653–660
Moehler TM, Neben K, Ho AD, Goldschmidt H (2001) Angiogenesis in hematologic malignancies. Ann Hematol 80:695–705
Dispenzieri A, Lacy MQ, Greipp PR (2001) Multiple myeloma in Winterobe’s clinical hematology, vol 2, 11th edn. Lipincott, Williams and Wilkins, Philadelphia, pp 2583–2636
Sezer O, Niemöller K, Eucker J, Jakob C, Kaufmann O, Zavrski I, Dietel M, Possinger M (2000) Bone marrow microvessel density is a prognostic factor for survival in patients with multiple myeloma. Ann Haematol 79:574–577
Fox SB, Leek RD, Weekes MP, Whitehouse RM, Gatter KC, Harris AL (1995) Quantitation and prognostic value of breast cancer angiogenesis: comparison of microvessel density. Chalkley count, and computer image analysis. J Pathol 177:275–283
Rajkumar SV, Leong T, Roche PC (2000) Prognostic value of bone marrow angiogenesis in multiple myeloma. Clin Cancer Res 6:3111–3116
Bhatti SS, Kumar L, Dinda AK, Dawar R (2006) Prognostic value of bone marrow angiogenesis in multiple myeloma: use of light microscopy as well as computerized image analyzer in the assessment of microvessel density and total vascular area in multiple myeloma and its correlation with various clinical, histological, and laboratory parameters. Am J Hematol 81:649–656
Bartl R, Frisch B, Fateh Moghadam A et al (1987) Histologic classification and staging of multiple myeloma: a retrospective and prospective study of 674 cases. Am J Clin Pathol 87:342–355
Vacca A, Ribatti D, Roccaro AM, Frigeri A, Dammacco F (2001) Bone marrow angiogenesis in patients with active multiple myeloma. Semin Oncol 28:543–550
Rajkumar SV, Witzig TE, Gertz MA, Griepp PR (1998) Computerized image analysis in the assessment of bone marrow angiogenesis in multiple myeloma. Blood 92suppI:100a
Vacca A, Ribatti D, Roncali L, Ranieri G, Serio G, Silvestris F, Dammacco F (1994) Bone marrow angiogenesis and progression in multiple myeloma. Br J Haematol 87:503–508
Munshi N, Wilson CS, Penn J, Epstein J, Singhal S, Hough A, Sanderson R, Desikan R, Seigel D, Mehta J, Barlogie B (1998) Angiogenesis in newly diagnosed multiple myeloma: poor prognosis with increased microvessel density in bone marrow biopsies (abstract). Blood 92(Suppl 1):98a
Singhal S, Mehta J, Desikan R, Ayers D, Robertson P, Eddlemen P, Munshi N, Anaissie E, Wilson C, Dhodapkar M, Zeldis J, Barlogie B (1999) N Eng J Med 341:1565–1571
Carter A, Hocherman I, Linn S, Cohen Y, Tatarsky I (1987) Prognostic significance of plasma cell morphology in multiple myeloma. Cancer 60:1060–1065
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Rana, C., Sharma, S., Agrawal, V. et al. Bone marrow angiogenesis in multiple myeloma and its correlation with clinicopathological factors. Ann Hematol 89, 789–794 (2010). https://doi.org/10.1007/s00277-010-0919-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00277-010-0919-z