The association between COX-2 expression and survival in myeloma patients

Increased cyclooxygenase-2 (COX-2) expression has been associated with poor prognosis in multiple myeloma (MM).

This study examined the relationship between COX-2 expression in bone marrow and prognosis in MM patients.

Bone marrow biopsy samples of 67 newly diagnosed MM patients were examined immunohistochemically for COX-2 expression. Mean age of the patients was 52.69 years (52.69 ± 9.17) and median follow-up time was 99.5 months (range: 6-170 months).

Of all patients, 30 (44.8%) were COX-2 positive and 37 (55.2%) were COX-2 negative. Median overall survival (OS) was 78 months (range: 54.07-101.92 months) among all patients, 75 months (range: 45.61-104.38 months) in COX-2-positive patients, and 98 months (range: 50.36-145.63 months) in COX-2-negative patients. Median progression-free survival (PFS) was 30 months (range: 3-134 months) in all, 29.5 months (range: 3-68 months) in COX-2-positive and 35 months (range: 3-134 months) in COX-2-negative patients. Statistically significant differences in OS and PFS between COX-2-positive and COX-2-negative patients were not observed (p = 0.84 and p = 0.22, respectively). Differences between the COX-2-positive and COX-2-negative patients in gender, hemoglobin, β2-microglobulin (β2M), creatinine, albumin, and disease stage were not statistically significant.

COX-2 expression neither had a role in prognosis nor significantly affected OS and PFS. We conclude that stem cell transplantation might eliminate the detrimental effects of COX-2 positivity. Larger series of patients are needed to investigate this observation.