Decrease of bone marrow angiogenesis in myeloma patients achieving a remission after chemotherapy

The impact of angiogenesis is well known for the growth and viability of so lid tumors. Fewer studies have been published relating angiogenesis to clin ical or pathological parameters in hematological malignancies. In this repo rt, we have estimated the bone marrow microvessel density (MVD) before and after conventional-dose or high-dose chemotherapy with autologous stem cell transplantation. Immunohistochemical CD34-stained paraffin-embedded bone m arrow biopsies of 21 patients with stage III multiple myeloma were studied. Microvessels were counted at 400 x magnification, and the mean number of v essels per area in each sample was noted as the MVD. The median MVD of all patients was 53.1 vessels/mm(2) (range 15.5-174.7 vessels/mm(2)) before tre atment and 29.3 vessels/mm(2) (range 0-221.1 vessels/mm2) after chemotherap y. The post-treatment MVD in the two groups of patients with and without re mission was significantly different (p = 0.001), whereas the pretreatment M VD was not. Responders but not. nonresponders showed a significant decrease of MVD after therapy in comparison to their pretreatment levels. The progr ession-free survival in patients who achieved a reduction in MVD after chem otherapy was significantly longer than in patients without a decrease in MV D (P = 0.006). Furthermore, we compared the MVD of patients after achieveme nt of a remission to MVD of 15 untreated stage I myeloma patients. The MVD of patients in remission was not statistically different from the MVD in st age I myeloma. These results underscore the impact of angiogenesis in myelo ma and give the first report that effective chemotherapy is accompanied by a significant decrease in bone marrow angiogenesis in this disease.