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Author Spotlight: Analyzing Bone Marrow Microenvironment in Murine Hematological Malignancies
Published on: November 10, 2023
Adverse prognostic impact of bone marrow microvessel density in multiple myeloma
Nuri Lee1,2, Hyewon Lee3, Soo Young Moon2
1Department of Laboratory Medicine, Center for Diagnostic Oncology, Hospital and Research Institute, National Cancer Center, Goyang, Korea.
Background:
Angiogenesis is important for the proliferation and survival of multiple myeloma (MM) cells. Bone marrow (BM) microvessel density (MVD) is a useful marker of angiogenesis and is determined by immunohistochemical staining with anti-CD34 antibody. This study investigated the prognostic impact of MVD and demonstrated the relationship between MVD and previously mentioned prognostic factors in patients with MM.
Methods:
The study included 107 patients with MM. MVD was assessed at initial diagnosis in a blinded manner by two hematopathologists who examined three CD34-positive hot spots per patient and counted the number of vessels in BM samples. Patients were divided into three groups according to MVD tertiles. Cumulative progression-free survival (PFS) and overall survival (OS) curves, calculated by using Kaplan-Meier method, were compared among the three groups. Prognostic impact of MVD was assessed by calculating Cox proportional hazard ratio (HR).
Results:
Median MVDs in the three groups were 16.8, 33.9, and 54.7. MVDs were correlated with other prognostic factors, including β2-microglobulin concentration, plasma cell percentage in the BM, and cancer stage according to the International Staging System. Multivariate Cox regression analysis showed that high MVD was an independent predictor of PFS (HR=2.57; 95% confidence interval, 1.22-5.42; P=0.013). PFS was significantly lower in the high MVD group than in the low MVD group (P=0.025). However, no difference was observed in the OS (P=0.428).
Conclusions:
Increased BM MVD is a marker of poor prognosis in patients newly diagnosed with MM. BM MVD should be assessed at the initial diagnosis of MM.
Insights
Increased bone marrow microvessel density (MVD) indicates a poorer prognosis for multiple myeloma (MM) patients. Assessing MVD at diagnosis can help predict progression-free survival.
Area of Science:
- Hematology
- Oncology
- Cancer Biology
Background:
- Angiogenesis supports multiple myeloma (MM) cell survival and proliferation.
- Bone marrow (BM) microvessel density (MVD) quantifies tumor angiogenesis.
- CD34 staining is used to determine MVD in MM patients.
Purpose of the Study:
- To evaluate the prognostic significance of MVD in MM.
- To explore the relationship between MVD and other MM prognostic factors.
Main Methods:
- 107 MM patients' BM samples were analyzed for MVD using CD34 staining.
- Patients were stratified into tertiles based on MVD.
- Kaplan-Meier and Cox regression analyses assessed survival outcomes (PFS, OS).
Main Results:
- High MVD correlated with elevated β2-microglobulin, higher plasma cell percentage, and advanced cancer stage.
- High MVD independently predicted shorter progression-free survival (PFS) (HR=2.57, P=0.013).
- PFS was significantly lower in high MVD groups compared to low MVD groups (P=0.025), but overall survival (OS) was not affected (P=0.428).
Conclusions:
- Elevated BM MVD signifies a poor prognosis in newly diagnosed MM.
- BM MVD assessment at initial diagnosis is recommended for MM patients.
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