Abstract
Multiple myeloma is a neoplasm of plasma cells characterised by the presence of M protein in serum and urine. Angiogenesis and proliferation play a major role in the pathogenesis of various neoplasms. The study evaluated proliferation and angiogenesis in 48 cases of myeloma, and correlated it with morphological and clinical parameters. The histomorphological features like plasma cell morphology, percentage of plasma cells and pattern of infiltration were studied in the bone marrow aspirate and trephine biopsy. Angiogenesis was assessed by calculating the microvessel density (MVD) using immunohistochemistry for CD34. Proliferation was assessed using Ki67 and CD38 highlighted the plasma cells. The mean Ki67 % was found to be significantly higher (19.6 % range 2–40 %) in poorly differentiated morphology compared to well differentiated morphology (4.06 % range 0.2–20 %) (p = 0.003). The mean MVD in the well differentiated morphology was 10.6 (range 1.2–47.4) compared to 20.3 (range 6.9–39.6) in the poorly differentiated morphology (p = 0.04). The mean MVD was 5.7 (range 1.2–12.8) in the interstitial pattern of infiltration compared to 20.04 (2.9–47.4) in the diffuse pattern (p < 0.0001). The mean MVD was 6.4 in cases with serum albumin >3.5 gm/dl compared to 13.3 in cases with serum albumin <3.5 gm/dl (p = 0.009). Both the Ki67 and MVD showed an increasing trend with the clinical staging. Thus the study of proliferation and angiogenesis in bone marrow biopsy is useful for prognosticating patients with multiple myeloma.
Similar content being viewed by others
References
Niesvizky R, Siegel D, Michaeli J (1993) Biology and treatment of multiple myeloma. Blood Rev 7(1):24–33
Durie BG, Salmon SE (1975) A clinical staging system for multiple myeloma. Correlation of measured myeloma cell mass with presenting clinical features, response to treatment, and survival. Cancer 36(3):842–854
Greipp PR, Miguel JS, Durie BGM, Crowley JJ, Barlogie B, Bladé J et al (2005) International staging system for multiple myeloma. J Clin Oncol 23(15):3412–3420
Palumbo A, Avet-Loiseau H, Oliva S, Lokhorst HM, Goldschmidt H, Rosinol L et al (2015) Revised international staging system for multiple myeloma: a report from international myeloma working group. J Clin Oncol 3(61):2267
Subramanian R, Basu D, Dutta TK (2009) Prognostic significance of bone marrow histology in multiple myeloma. Indian J Cancer 46(1):40–45
Xu JL, Lai R, Kinoshita T, Nakashima N, Nagasaka T (2002) Proliferation, apoptosis, and intratumoral vascularity in multiple myeloma: correlation with the clinical stage and cytological grade. J Clin Pathol 55(7):530–534
Sailer M, Vykoupil KF, Peest D, Coldewey R, Deicher H, Georgii A (1995) Prognostic relevance of a histologic classification system applied in bone marrow biopsies from patients with multiple myeloma: a histopathological evaluation of biopsies from 153 untreated patients. Eur J Haematol 54(3):137–146
Pich A, Chiusa L, Marmont F, Navone R (1997) Risk groups of myeloma patients by histologic pattern and proliferative activity. Am J Surg Pathol 21(3):339–347
Drach J, Gattringer C, Glassl H, Drach D, Huber H (1992) The biological and clinical significance of the KI-67 growth fraction in multiple myeloma. Hematol Oncol 10(2):125–134
Thaler J, Fechner F, Herold M, Huber H (1994) Interleukin-6 in multiple myeloma: correlation with disease activity and Ki-67 proliferation index. Leuk Lymphoma 12(3–4):265–271
Sharma S, Sharma MC, Sarkar C (2005) Morphology of angiogenesis in human cancer: a conceptual overview, histoprognostic perspective and significance of neoangiogenesis. Histopathology 46(5):481–489
Vacca A, Ribatti D, Roncali L, Ranieri G, Serio G, Silvestris F et al (1994) Bone marrow angiogenesis and progression in multiple myeloma. Br J Haematol 87(3):503–508
Rajkumar SV, Leong T, Roche PC, Fonseca R, Dispenzieri A, Lacy MQ et al (2000) Prognostic value of bone marrow angiogenesis in multiple myeloma. Clin Cancer Res 6(8):3111–3116
Alexandrakis MG, Passam FH, Dambaki C, Pappa CA, Stathopoulos EN (2004) The relation between bone marrow angiogenesis and the proliferation index Ki-67 in multiple myeloma. J Clin Pathol 57(8):856–860
Alexandrakis MG, Neonakis IK, Pappa CA, Konsolas I, Kokonozaki M, Vyzoukaki R et al (2015) Immunohistochemical expression of endoglin offers a reliable estimation of bone marrow neoangiogenesis in multiple myeloma. J Cancer Res Clin Oncol 141(8):1503–1509
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Priyadarshini, S.G., Basu, D., Kar, R. et al. Proliferation and Angiogenesis Using Immunohistochemistry in Prognosticating Multiple Myeloma. Indian J Hematol Blood Transfus 32, 418–423 (2016). https://doi.org/10.1007/s12288-016-0642-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12288-016-0642-6