Combined measurement of plasma cell proliferative and apoptotic index in multiple myeloma defines patients with good and poor prognosis.

We assessed plasma cell proliferation (by propidium iodide index, PC-PI) and apoptosis (by annexin-V index PC-AI) for the estimation of overall survival (OS) in multiple myeloma (MM) patients. 181 patients with newly diagnosed MM were assessed, treated using conventional chemotherapy. The values best discriminating patients with poor prognosis were PC-PI>3.0% and PC-AI<4.75%, and for good prognosis PC-PI≤3.0% and PC-AI≥4.75%. The median OS was 8 months vs 40 months, p=0.0002. Our results suggest that combined measurement of plasma cell proliferation and apoptosis creates a unique strong prognostic factor based on growth characteristics of the tumor clone.