Bone marrow angiogenesis in multiple myeloma: effect of therapy
Bone marrow angiogenesis in multiple myeloma: effect of therapy
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DOI：
10.1046/j.1365-2141.2002.03871.x
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发表时间：
2002-12-01
影响因子：
6.5
通讯作者：
Rajkumar, SV
中科院分区：
文献类型：
--
作者：
Kumar, S;Fonseca, R;Rajkumar, SV
最近的研究表明，血管生成在包括多发性骨髓瘤在内的血液系统恶性肿瘤中起作用。多发性骨髓瘤的特点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，我们用两种方法对初诊多发性骨髓瘤患者的骨髓血管生成进行了评估，并与标准化疗后的骨髓结果进行了比较。治疗前，骨髓血管生成程度增加和骨髓浆细胞标记指数(PCLI)高预示着较差的存活率。根据微血管密度(MVD)估计低、中、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。治疗后微血管密度无明显变化。然而，当至少有部分反应的患者被单独考虑时，他们的微血管密度下降。治疗后PCLI对生存有预测作用，但治疗后MVD不能。视觉分级与MVD测定的血管生成有较好的相关性。我们的结论是，骨髓血管生成程度是多发性骨髓瘤患者的一个预后指标，治疗后不会明显下降。
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, 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.