O. Sezer et al., Decrease of bone marrow angiogenesis in myeloma patients achieving a remission after chemotherapy, EUR J HAEMA, 66(4), 2001, pp. 238-244
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.