Kumar Shaji, Fonseca Rafael, Dispenzieri Angela, Lacy Martha Q, Lust John A, Witzig Thomas E, Gertz Morie A, Kyle Robert A, Greipp Philip R, Rajkumar S Vincent
Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Br J Haematol. 2002 Dec;119(3):665-71. doi: 10.1046/j.1365-2141.2002.03871.x.
Recent studies have demonstrated that angiogenesis has a role in haematological malignancies, including multiple myeloma. Multiple myeloma is characterized by inevitable relapse after standard or high-dose chemotherapy. To study the effect of chemotherapy on bone marrow angiogenesis in patients with multiple myeloma, we used two methods to evaluate bone marrow angiogenesis in patients with newly diagnosed multiple myeloma, comparing these findings with those from bone marrow obtained after standard chemotherapy. Before therapy, an increased degree of bone marrow angiogenesis and a high bone marrow plasma cell labelling index (PCLI) were predictive of poorer survival. As estimated by microvessel density (MVD), the median survivals for patients with low-grade, intermediate-grade and high-grade angiogenesis were 77, 30 and 14 months respectively. After therapy, the MVD did not change significantly. However, when patients with at least a partial response were considered separately, they showed a decrease in MVD. Post-therapy PCLI was predictive of survival, but post-therapy MVD was not. There was good correlation between angiogenesis estimated by visual grading and that determined by MVD assessment. We conclude that the degree of bone marrow angiogenesis is a prognostic marker in patients with multiple myeloma and does not decrease significantly after therapy.
近期研究表明，血管生成在血液系统恶性肿瘤（包括多发性骨髓瘤）中发挥作用。多发性骨髓瘤的特征是在标准或大剂量化疗后不可避免地复发。为了研究化疗对多发性骨髓瘤患者骨髓血管生成的影响，我们采用两种方法评估新诊断的多发性骨髓瘤患者的骨髓血管生成情况，并将这些结果与标准化疗后获得的骨髓结果进行比较。治疗前，骨髓血管生成程度增加和高骨髓浆细胞标记指数（PCLI）预示着较差的生存率。根据微血管密度（MVD）估计，低级别、中级别和高级别血管生成患者的中位生存期分别为77个月、30个月和14个月。治疗后，MVD没有显著变化。然而，当单独考虑至少有部分缓解的患者时，他们的MVD有所下降。治疗后的PCLI可预测生存率，但治疗后的MVD则不能。视觉分级估计的血管生成与MVD评估确定的血管生成之间存在良好的相关性。我们得出结论，骨髓血管生成程度是多发性骨髓瘤患者的一个预后标志物，并且在治疗后不会显著降低。
