IMAGE-ANALYSIS IN MULTIPLE-MYELOMA AT DIAGNOSIS - CORRELATION WITH CYTOGENETIC STUDY

The DNA content of plasma cells (DNA Index or DI) was determined after Feulgen reaction using computed image analysis in 46 patients with mu ltiple myeloma at diagnosis. Aneuploidy was found in 40/46 (87.0%) pat ients; 27 (58.7%) were hyperdiploid (DI = 1.05-1.45), 11 (24.0%) were hypodiploid (DI = 0.90-0.95), and two (4.3%) were biclonal. Cytogeneti c study showed at least one abnormal mitosis in 21/46 (45.7%) cases. A ll patients with numeric changes had aneuploid DI, and thus confirmed DI greater than or equal to 1.05 and DI less than or equal to 0.95 as good limits for aneuploidy with image analysis. Since abnormal karyoty pes were observed mainly in stages II and III (55.6% and 54.5%, respec tively) rather than in stage I (26.7%), aneuploid DI was found in most patients in all three stages, namely in all 15/15 (100%) patients in stage I, The prognostic value of aneuploidy was difficult to ascertain in our series. Hypodiploidy or DI > 1.15 was not especially associate d with aggressive disease, as it was observed in 7/15 patients in stag e I; however, with the same limits, patients with stages II and III we re refractory to first-line chemotherapy. Image analysis is a highly s ensitive method showing aneuploidy in most patients with MM at diagnos is and, in association with cylogenetic study, may help to better unde rstand the pathogenesis of the disease. The independent prognostic val ue of aneuploidy was not fully established in this report.