Prognostic Relevances of Bone Marrow Features in Patients with Multiple Myeloma.
- Author:
Sang Hyun HWANG
;
Chan Jeoung PARK
;
Hyun Sook CHI
;
Je Hwan LEE
;
Woo Kun KIM
;
Sang Hee KIM
- Publication Type:Original Article
- Keywords:
Multiple myeloma, Prognosis;
Bone marrow;
Cytology;
Infiltration (Volume, Pattern)
- MeSH:
Aspirations (Psychology);
Biopsy;
Bone Marrow*;
Chungcheongnam-do;
Fibrosis;
Hematopoiesis;
Humans;
Multiple Myeloma*;
Prognosis
- From:Korean Journal of Clinical Pathology
1999;19(1):8-14
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Survival time of patients with multiple myeloma has been reported to be closely related to the cytology of bone marrow smears and the histologic features of bone marrow biopsies. However, there have been many differences in morphological criteria applied by various authors. In this study, we evaluated the prognostic relevance of bone marrow features in patients with multple myeloma by investigation of the cytologic feature and the histologic patterns. MATERIALS AND METHODS: One hundred and seven previously untreated patients with multiple myeloma, admitted to Asan Medical Center, between 1989 and 1997, were studied. Bone marrow aspirations and biopsies were analyzed according to the criteria such as cytologic differentiation, volume of infiltration, pattern of infiltration, degree of hematopoiesis, and presence of fibrosis. RESULTS: 64 cases (59.8%) of 107 patients with multiple myeloma were plasmacytic type and 43 cases (40.2%) were plasmablastic type. Each median survival time was 35.0 months and 18.0 months (P<0.05). The patients with more than 25% of plasmablasts showed shorter median survival time than those with 1ess than 25% (18 months vs 38.9 months, P<0.05). The patients with nodular or packed marrow pattern revealed poorer prognosis than those with interstitial or interstitial/nodular pattern (P<0.05). The patients of plasmablastic type disclosed larger volume of myeloma cell infiltration and more packed marow pattern than those of plasmacytic type. CONCLUSIONS: The cytologic differentiation, the volume of infiltration and the patterns of infiltration were reliable predictors of survival in myeloma patients. Thus, for the prognostic evaluation and therapeutic plans, the descriptions for cytologic differentiation (especially percentage of plasmablasts), volume of infiltration and pattern of infiltration should be included in the bone marrow interpretation of multiple myeloma.
