Bone marrow biopsy in monoclonal gammopathies: correlations between pathological findings and clinical data. The Cooperative Group for Study and Treatment of Multiple Myeloma.

Riccardi, Alberto; Ucci, G.; Luoni, R; Castello, A; Coci, A; Magrini, Umberto; Ascari, E

doi:10.1136/jcp.43.6.469

Cited by 28 publications

(18 citation statements)

References 24 publications

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“…All preparations were performed by a single histopathologist experienced in the diagnosis of MM. For analysis of histological and cytological findings a semi‐quantitative classification was applied (Table II), adapted and modified from a system proposed by Riccardi et al (1990). To assess vascular density, CD34‐stained bone marrow biopsies were digitalized using an Aperio slide scanner (Aperio, Vista, CA, USA) and the microvessel number was calculated per 50 000 μm 2 using the microvessel density algorithm (Aperio).…”

Section: Methodsmentioning

confidence: 99%

Diffusion‐weighted imaging for non‐invasive and quantitative monitoring of bone marrow infiltration in patients with monoclonal plasma cell disease: a comparative study with histology

Hillengaß

Bäuerle

Bartl³

et al. 2011

Br J Haematol

134

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Summary Bone marrow plasma cell infiltration is a crucial parameter of disease activity in monoclonal plasma cell disorders. Until now, the only way to quantify such infiltration was bone marrow biopsy or aspiration. Diffusion‐weighted imaging (DWI) is a magnetic resonance imaging‐technique that may mirror tissue cellularity by measuring random movements of water molecules. To investigate if DWI is capable of assessing bone marrow cellularity in monoclonal plasma cell disease, we investigated 56 patients with multiple myeloma or monoclonal gammopathy of undetermined significance, and 30 healthy controls using DWI of the pelvis and/or the lumbar spine. In 25 of 30 patients who underwent biopsy, bone marrow trephine and DWI could be compared. Of the patients with symptomatic disease 15 could be evaluated after systemic treatment. There was a positive correlation between the DWI‐parameter apparent diffusion coefficient (ADC) and bone marrow cellularity as well as micro‐vessel density (P < 0·001 respectively). ADC was significantly different between patients and controls (P < 0·01) and before and after systemic therapy (P < 0·001). In conclusion, DWI enabled bone marrow infiltration to be monitored in a non‐invasive, quantitative way, suggesting that after further investigations on larger patient groups this might become an useful tool in the clinical work‐up to assess tumour burden.

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Section: Methodsmentioning

confidence: 99%

Diffusion‐weighted imaging for non‐invasive and quantitative monitoring of bone marrow infiltration in patients with monoclonal plasma cell disease: a comparative study with histology

Hillengaß

Bäuerle

Bartl³

et al. 2011

Br J Haematol

134

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“…Diagnosis and staging Diagnosis of MM required the presence of at least two of the three following features: (a) a serum and/or urine monoclonal component (MC); (b) a bone marrow plasma cell (BMPC) infiltration greater than 20%, as evaluated on trephine BM biopsy (Riccardi et al, 1990); (c) the presence of osteolytic lesions unattributed to other causes. For diagnosis of non-secretory MM (i.e.…”

Section: Methodsmentioning

confidence: 99%

Treatment of multiple myeloma according to the extension of the disease: a prospective, randomised study comparing a less with a more aggressive cytostatic policy

Riccardi

Ucci²,

Luoni³

et al. 1994

Br J Cancer

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Summary The purpose of the study was to ascertain whether the prognostic significance of staging in multiple myeloma (MM) is influenced by the aggressiveness of effective induction treatment and/or by continuing or discontinuing maintenance chemotherapy. Patients patients, still independent of both induction and post-induction policies. In MM, the significance of staging for survival is independent of both the aggressiveness of induction policy and of continuing or discontinuing maintenance chemotherapy after the maximal tumour reduction has been achieved. Both MPH-P and the association of PTC, VCR and P are effective in inducing first response and also second response in patients failing on the alternative regimen, but PTC-VCR-P causes more side-effects. Thus, the overwhelming majority of patients with MM can safely be given MPH-P as first therapy, and this treatment may be delayed in early disease.Attempts to improve survival of the general population of patients with multiple myeloma (MM) have been focused mainly on chemotherapies more aggressive than the standard melphalan-prednisone (MPH-P) regimen, irrespective of the extent of the disease. Little has been done to evaluate, in prospective studies, the survival value of tailoring therapy according to the stage of the disease, as is done with several other tumours in spite of there being no doubt that early Correspondence: A. Riccardi,

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“…Interesting observations can be made by analysing features concerning bone disease. An evaluation of bone marrow histology confirmed that all the characteristics investigated could distinguish MM from MGUS [9]. In particular, less differentiated plasmoblastic cytology and heavy fibrosis were hallmarks of MM and were seldom found among MGUS (Table 3).…”

Section: Discussionmentioning

confidence: 70%

“…Bone marrow (BM) biopsies were reviewed not only for per cent BMPC but also for overall BM cellularity, pattern (diffuse or interstitial) of PC infiltration, cytologic (plasmocytic or plasmoblastic) appearance of BMPC, residual haemopoiesis, and osteoclastic activity [9].…”

Section: Clinical and Laboratory Evaluationmentioning

confidence: 99%

Presenting features of monoclonal gammopathies: an analysis of 684 newly diagnosed cases

Ucci

Riccardi

Luoni

et al. 1993

Journal of Internal Medicine

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Bone marrow biopsy in monoclonal gammopathies: correlations between pathological findings and clinical data. The Cooperative Group for Study and Treatment of Multiple Myeloma.

Cited by 28 publications

References 24 publications

Diffusion‐weighted imaging for non‐invasive and quantitative monitoring of bone marrow infiltration in patients with monoclonal plasma cell disease: a comparative study with histology

Diffusion‐weighted imaging for non‐invasive and quantitative monitoring of bone marrow infiltration in patients with monoclonal plasma cell disease: a comparative study with histology

Treatment of multiple myeloma according to the extension of the disease: a prospective, randomised study comparing a less with a more aggressive cytostatic policy

Presenting features of monoclonal gammopathies: an analysis of 684 newly diagnosed cases

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