Evaluation of argyrophilic nucleolar organiser regions (AgNORs) in multiple myeloma
S I Papadhimitriou1, D Daskalopoulou, P Tsaftaridis
1Department of Clinical Haematology, Greek Cancer Institute, Aghios Savvas Hospital, Athens, Greece.
Aim:
To investigate the prognostic value of argyrophylic nucleolar organiser regions (AgNORs) in multiple myeloma.
Methods:
Bone marrow aspirates from 55 newly diagnosed patients with multiple myeloma were stained with the one step AgNO3 technique. The mean number of AgNORs in each plasma cell nucleus (AgNOR count) was tested for a possible correlation with other clinical and laboratory variables at presentation (clinical stage, substage, heavy and light chain isotype, haemoglobin concentration, platelet count, marrow infiltration rate, degree of skeletal lesions, M protein concentration, plasma cell morphology, and serum concentrations of calcium, albumin, lactate dehydrogenase, C reactive protein, and beta 2 microglobulin) and with outcome (response to first line treatment, first remission duration, and overall survival).
Results:
A significant association between mean (SD) AgNOR count was found only for clinical stage (stage I, 3.09 (1.19); stage II, 3.80 (1.53); stage III, 5.28 (1.79); p < 0.005) and, from all stage determinants, only for M protein concentration (high, 5.92 (1.80); low, 4.01 (1.92); p < 0.001). There was a linear relation between AgNOR count and serum M protein concentration for patients with both IgG (r = 0.450; p < 0.01) and IgA (r = 0.768; p < 0.002) producing multiple myeloma.
Conclusions:
Unlike previous investigations, no clear prognostic value for the AgNOR count was found in multiple myeloma. Instead, the results indicate that the AgNOR count might be an index for M protein synthesis rate. This is consistent with other findings in tissues with low proliferative potential and high protein synthetic activity, and calls for a cautious interpretation of AgNORs in malignancies with similar features.
Insights
The argyrophylic nucleolar organiser region (AgNOR) count in multiple myeloma does not appear to be a reliable prognostic marker. Instead, AgNOR count may reflect M protein synthesis rate, not disease progression.
Area of Science:
- Hematology
- Oncology
- Cell Biology
Background:
- Multiple myeloma is a hematologic malignancy characterized by uncontrolled proliferation of plasma cells.
- Argyrophylic nucleolar organiser regions (AgNORs) are structures within the nucleus associated with cell proliferation and protein synthesis.
- Previous studies have suggested AgNORs as a potential prognostic indicator in various cancers.
Purpose of the Study:
- To evaluate the prognostic significance of AgNOR counts in newly diagnosed multiple myeloma patients.
- To determine if AgNOR counts correlate with established clinical and laboratory parameters of multiple myeloma.
- To assess the relationship between AgNOR counts and treatment outcomes, including remission duration and overall survival.
Main Methods:
- Bone marrow aspirates from 55 multiple myeloma patients were analyzed.
- Plasma cells were stained using the AgNO3 technique to determine the mean AgNOR count per nucleus.
- AgNOR counts were correlated with clinical stage, M protein concentration, and other laboratory variables.
Main Results:
- AgNOR count showed a significant association with clinical stage (p < 0.005) and M protein concentration (p < 0.001).
- A linear relationship was observed between AgNOR count and serum M protein concentration for IgG and IgA myeloma.
- No clear correlation was found between AgNOR count and treatment response, remission duration, or overall survival.
Conclusions:
- The AgNOR count does not appear to have independent prognostic value in multiple myeloma.
- AgNOR count may serve as an indicator of M protein synthesis rate rather than a marker of disease aggressiveness.
- Interpretation of AgNOR counts in multiple myeloma should be cautious, considering its potential role as a marker of protein synthesis activity.
