Assessment of Bone Marrow Fibrosis and Angiogenesis in Monitoring Patients With Multiple Myeloma

Abstract

The aim of our study was to emphasize the importance of accurate and standardized techniques for detailed monitoring of the microenvironment in multiple myeloma (MM). Bone marrow fibrosis, angiogenesis, and plasma cell infiltrates in bone marrow biopsy (BMB) samples at the time of diagnosis and on completion of therapy were analyzed for 42 patients with newly diagnosed MM. Computerized image analysis was used for all slides stained with anti-CD138 and anti-CD34. The patients with fibrosis in pretreatment BMB samples had significantly higher microvessel density (MVD) and plasma cell infiltrates. In posttreatment BMB samples, nonresponders had a significantly higher frequency and grade of fibrosis and higher values of MVD, total vascular area, and plasma cell percentage. The overall survival of nonresponders and patients with increased marrow fibrosis in posttreatment BMB samples was significantly shorter. The obtained results confirm that complex morphologic examination of the bone marrow microenvironment during the monitoring of MM can provide better prognostic significance.

B lymphocytes directly contribute to tissue fibrosis in patients with IgG4-related disease

“…Indeed, in contrast to SS, tissue fibrosis represents an established negative prognostic factor for end-stage organ damage in patients with IgG 4 -RD and for overall survival in patients with MM. 4,50 Of note, although plasmablasts induced a significant increase of collagen secretion in cocultures compared with naive and memory B cells, the former were no more stimulatory than naive B cells in terms of PDGF-B, CCL4, CCL5, and CCL11 expression by fibroblasts, suggesting that plasmablasts stimulate fibroblast activation through mechanisms that differ from other B-cell subsets. The surprising observation that plasmablasts from patients with IgG 4 -RD expressed type I collagen genes, for instance, raises the possibility that the increased collagen production observed in fibroblasts cocultured with plasmablasts (and B cells in general) was due at least in part to the direct secretion of collagenous proteins by B lymphocytes.…”

Adverse Prognostic Impact of Bone Marrow Microvessel Density in Multiple Myeloma

“…In addition, manual counting of MVDs in BM samples is a limitation because of interobserver differences, especially while counting very small arterioles and venules and exclusion of areas with non-specific staining. Because the difference in the mean (SD) MVDs determined by the two independent hematopathologists was statistically significant, more standardized MVD assessments such as those involving computerized image analyzers should be performed in the future [ 11 14 22 23 24 ]. Thus, the present results should be validated by using computer-based analysis systems.…”

Comparative Analysis of Diagnostic Value of Simultaneous Use of Bone Marrow Aspiration and Biopsy in Routine Haematology Practice: An Institutional Experience

“…7 Also the role of BMB for detection of minimal residual disease after treatment in case of multiple myeloma and leukaemia are very useful. 14 We have encountered six cases of MPN's out of which diagnosis was possible to be made from PBF and BMA in 2 cases only rest four cases were confirmed on BMB. Role of trephine biopsy is not only in differentiation of MPN but also to assess the overall marrow cellularity, histotopography, morphology of megakaryocytes as well as blasts, and degree of Myelofibrosis.…”