Bone marrow findings and clinical outcomes of the multiple myeloma: A retrospective study
Keywords:
Plasma cell neoplasm, plasma cell morphology, multiple myeloma, bone marrow finding, overall survivalAbstract
Objectives : Our study primarily describes the survival of multiple myeloma (MM) patients and focuses about the correlation between these findings using various pathological parameters and clinical outcomes as median survival time.
Methods : Our retrospective study includes all bone marrow biopsy samples with pathologically proven first-diagnosis plasma cell neoplasm from 1st January 2008 to 31st December 2019 at Srinagarind Hospital.
Results : 253 first-diagnosis plasma cell neoplasm cases underwent survival analysis showing the median survival time was 2.12 years (95%CI: 1.83 - 2.64 years). Forty-four cases (17.4%) showed intermediate and immature neoplastic morphologies affecting the adverse outcome compared with the mature group exhibiting the median time survival was 1.83 years (95% CI: 0.70 - 2.17) and 2.44 years (95% CI: 1.83 - 3.01), respectively (p-value 0.03) (HR 1.5, 95%CI: 1.04 - 2.18, p-value 0.03).
Conclusions : Even though much less frequently, the morphology of neoplastic plasma cells, particularly the immature group, still has an impact on the poorer prognosis.
References
Kazandjian D. Multiple myeloma epidemiology and survival: A unique malignancy. Semin Oncol. 2016;43(6):676-681. doi:10.1053/j.seminoncol.2016.11.004
Cancer today. Accessed April 23, 2023. http://gco.iarc.fr/today/home
Bartl R, Frisch B, Fateh-Moghadam A, Kettner G, Jaeger K, Sommerfeld W. Histologic Classification and Staging of Multiple Myeloma: A Retrospective and Prospective Study of 674 Cases. Am J Clin Pathol. 1987;87(3):342-355. doi:10.1093/ajcp/87.3.342
Sukpanichnant S, Cousar JB, Leelasiri A, Graber SE, Greer JP, Collins RD. Diagnostic criteria and histologic grading in multiple myeloma: histologic and immunohistologic analysis of 176 cases with clinical correlation. Hum Pathol. 1994;25(3):308-318. doi:10.1016/0046-8177(94)90204-6
Bartl R, Frisch B. Diagnostic morphology in multiple myeloma. Curr Diagn Pathol. 1995;2(4):222-235. doi:10.1016/S0968-6053(05)80022-5
Athanasiou E, Kaloutsi V, Kotoula V, et al. Cyclin D1 overexpression in multiple myeloma. A morphologic, immunohistochemical, and in situ hybridization study of 71 paraffin-embedded bone marrow biopsy specimens. Am J Clin Pathol. 2001;116(4):535-542. doi:10.1309/BVT4-YP41-LCV2-5GT0
Seili-Bekafigo I, Valković T, Babarović E, Duletić-Načinović A, Jonjić N. Myeloma cell morphology and morphometry in correlation with clinical stages and survival: Myeloma Cell Morphology in Prognosis. Diagn Cytopathol. 2013;41(11):947-954. doi:10.1002/dc.22986
Møller HEH, Preiss BS, Pedersen P, et al. Clinicopathological features of plasmablastic multiple myeloma: a population-based cohort. APMIS. 2015;123(8):652-658. doi:10.1111/apm.12411
Bain BJ, Clark DM, Wilkins B. Bone Marrow Pathology. Fifth edition. Wiley-Blackwell; 2019.
Rajkumar SV, Fonseca R, Lacy MQ, et al. Plasmablastic Morphology Is an Independent Predictor of Poor Survival After Autologous Stem-Cell Transplantation for Multiple Myeloma. J Clin Oncol. 1999;17(5):1551-1551. doi:10.1200/JCO.1999.17.5.1551
Rajkumar SV, Dimopoulos MA, Palumbo A, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014;15(12):e538-e548. doi:10.1016/S1470-2045(14)70442-5
Subramanian R, Basu D, Dutta TK. Significance of bone marrow fibrosis in multiple myeloma. Pathology (Phila). 2007;39(5):512-515. doi:10.1080/00313020701570038
Babarović E, Valković T, Štifter S, et al. Assessment of Bone Marrow Fibrosis and Angiogenesis in Monitoring Patients With Multiple Myeloma. Am J Clin Pathol. 2012;137(6):870-878. doi:10.1309/AJCPT5Y2JRIUUCUB
Paul B, Zhao Y, Loitsch G, et al. The impact of bone marrow fibrosis and JAK2 expression on clinical outcomes in patients with newly diagnosed multiple myeloma treated with immunomodulatory agents and/or proteasome inhibitors. Cancer Med. 2020;9(16):5869-5880. doi:10.1002/cam4.3265
Xu JL, Lai R, Kinoshita T, Nakashima N, Nagasaka T. Proliferation, apoptosis, and intratumoral vascularity in multiple myeloma: correlation with the clinical stage and cytological grade. J Clin Pathol. 2002;55(7):530-534. doi:10.1136/jcp.55.7.530
Kawano Y, Moschetta M, Manier S, et al. Targeting the bone marrow microenvironment in multiple myeloma. Immunol Rev. 2015;263(1):160-172. doi:10.1111/imr.12233
Xu Y, Deng S hui, Mai Y jie, et al. [The analysis of prognostic variables in 123 patients with multiple myeloma]. Zhonghua Xue Ye Xue Za Zhi Zhonghua Xueyexue Zazhi. 2007;28(5):330-334.
Greipp PR, Leong T, Bennett JM, et al. Plasmablastic morphology--an independent prognostic factor with clinical and laboratory correlates: Eastern Cooperative Oncology Group (ECOG) myeloma trial E9486 report by the ECOG Myeloma Laboratory Group. Blood. 1998;91(7):2501-2507.
Al-Quran SZ, Yang L, Magill JM, Braylan RC, Douglas-Nikitin VK. Assessment of bone marrow plasma cell infiltrates in multiple myeloma: the added value of CD138 immunohistochemistry. Hum Pathol. 2007;38(12):1779-1787. doi:10.1016/j.humpath.2007.04.010
Weltgesundheitsorganisation. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Revised 4th edition. (Swerdlow SH, Campo E, Harris NL, et al., eds.). International Agency for Research on Cancer; 2017.
Van der Walt J, Orazi A, Arber DA. Diagnostic Bone Marrow Haematopathology. Cambridge University Press; 2021.
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