Bone marrow microvessel density is a prognostic factor for survival in patients with multiple myeloma

The importance of neoangiogenesis for the progressive growth and viability of solid tumors is well established. Recently, there has been growing evide nce that angiogenesis might also be important in hematological malignancies , but only few data are available. In this report, we have studied the impa ct of bone marrow microvessel density and survival in patients with multipl e myeloma (MM). Immunohistochemical CD34 stained paraffin-embedded bone mar row biopsies of 44 patients with newly diagnosed MM were studied. Microvess els were counted in 400 x magnification and the mean number of vessels per area in each sample was noted as the microvessel density (MVD). The median MVD was 48 vessels/mm(2). the range was 0-125 vessels/mm(2). Using a cut-of f value of the median MVD in the Kaplan-Meier analysis, the median survival was 22.2 months in the group with the higher MVD and was not reached in th e group with the lower MVD (P<0.01). In a multivariate Cox regression analy sis, using previously identified prognostic factors <beta>2-microglobulin, C-reactive protein (CRP), and age, MVD remained significant as a prognostic factor (P<0.03).