Niloofar Arefi Sigaroudi, Mohsen Vakili Sadeghi, Housein Ghorbani, Davood Jahansouz, Hoda Shirafkan, Mohammad Ranaee
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The secondary outcomes were also OS based on angiogenesis using IHC marker CD34, nuclear atypia level, BM involvement pattern and the presence of fibrosis in bone marrow specimens. All biopsy specimens assessed using light microscopy on Hematoxylin and Eosin and IHC staining. Giemsa staining assessed for aspirate specimens.</p><p><strong>Results: </strong>Of 93 patients, 63.4% were dead. Median survival was 34.0 months (95% CI [24.6; 43.3]) and the average age at diagnosis was 65 years (highest 84 and lowest 40). Patients with bone marrow plasma cell count of over 70%, had a hazard ratio (HR) of death of 4.7 times more than those with plasma cell count between 10-25%. Similarly, diffuse infiltration pattern (HR 4.67) and blastic morphology (HR 4.17) associated with a significant worse prognosis (p=0.03).</p><p><strong>Conclusion: </strong>Comparing to laboratory-based ISS, wider HR of death spectrum in this study proposes a potential more precise, robust and easy-to-use prognostication tool.</p>","PeriodicalId":9646,"journal":{"name":"Caspian Journal of Internal Medicine","volume":"16 3","pages":"562-569"},"PeriodicalIF":1.0000,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329366/pdf/","citationCount":"0","resultStr":"{\"title\":\"Prognosis of multiple myeloma patients based on histopathological evaluation of bone marrow.\",\"authors\":\"Niloofar Arefi Sigaroudi, Mohsen Vakili Sadeghi, Housein Ghorbani, Davood Jahansouz, Hoda Shirafkan, Mohammad Ranaee\",\"doi\":\"10.22088/cjim.16.3.562\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Multiple myeloma is still one of deadliest malignancies known. Although many attempts to prognosticate the disease have been done like the International Staging System (ISS), most of the proposed prognostic tools are based merely on laboratory tests and hence prone to analytical errors in large and high-volume centers. This study aims to evaluate the prognostic effectiveness of histopathologic components of bone marrow and compare it to the results of laboratory-based prognostic tools.</p><p><strong>Methods: </strong>This cross-sectional study, bone marrow specimens of 93 multiple myeloma patients underwent aspiration and biopsy evaluated. The primary outcome was overall survival (OS) based on plasma cell percentage. The secondary outcomes were also OS based on angiogenesis using IHC marker CD34, nuclear atypia level, BM involvement pattern and the presence of fibrosis in bone marrow specimens. All biopsy specimens assessed using light microscopy on Hematoxylin and Eosin and IHC staining. Giemsa staining assessed for aspirate specimens.</p><p><strong>Results: </strong>Of 93 patients, 63.4% were dead. Median survival was 34.0 months (95% CI [24.6; 43.3]) and the average age at diagnosis was 65 years (highest 84 and lowest 40). Patients with bone marrow plasma cell count of over 70%, had a hazard ratio (HR) of death of 4.7 times more than those with plasma cell count between 10-25%. 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引用次数: 0
摘要
背景:多发性骨髓瘤仍然是已知的最致命的恶性肿瘤之一。虽然许多预测疾病的尝试已经完成,如国际分期系统(ISS),但大多数建议的预测工具仅仅基于实验室测试,因此在大型和高容量的中心容易出现分析错误。本研究旨在评估骨髓组织病理学成分的预后效果,并将其与基于实验室的预后工具的结果进行比较。方法:对93例多发性骨髓瘤患者的骨髓标本进行抽吸和活检。主要终点是基于浆细胞百分比的总生存期(OS)。次要结果还包括基于IHC标志物CD34的血管生成、核异型性水平、骨髓浸润模式和骨髓标本中纤维化的存在的OS。所有活检标本采用苏木精和伊红光镜及免疫组化染色进行评估。吸入标本的吉姆萨染色评估。结果:93例患者死亡63.4%。中位生存期为34.0个月(95% CI [24.6;[43.3]),平均诊断年龄65岁(最高84岁,最低40岁)。骨髓浆细胞计数大于70%的患者的死亡危险比(HR)是浆细胞计数在10 ~ 25%之间的患者的4.7倍。同样,弥漫性浸润模式(HR 4.67)和母细胞形态(HR 4.17)与预后明显较差相关(p=0.03)。结论:与基于实验室的ISS相比,本研究中更广泛的死亡谱HR提供了一种潜在的更精确、更稳健、更易于使用的预测工具。
Prognosis of multiple myeloma patients based on histopathological evaluation of bone marrow.
Background: Multiple myeloma is still one of deadliest malignancies known. Although many attempts to prognosticate the disease have been done like the International Staging System (ISS), most of the proposed prognostic tools are based merely on laboratory tests and hence prone to analytical errors in large and high-volume centers. This study aims to evaluate the prognostic effectiveness of histopathologic components of bone marrow and compare it to the results of laboratory-based prognostic tools.
Methods: This cross-sectional study, bone marrow specimens of 93 multiple myeloma patients underwent aspiration and biopsy evaluated. The primary outcome was overall survival (OS) based on plasma cell percentage. The secondary outcomes were also OS based on angiogenesis using IHC marker CD34, nuclear atypia level, BM involvement pattern and the presence of fibrosis in bone marrow specimens. All biopsy specimens assessed using light microscopy on Hematoxylin and Eosin and IHC staining. Giemsa staining assessed for aspirate specimens.
Results: Of 93 patients, 63.4% were dead. Median survival was 34.0 months (95% CI [24.6; 43.3]) and the average age at diagnosis was 65 years (highest 84 and lowest 40). Patients with bone marrow plasma cell count of over 70%, had a hazard ratio (HR) of death of 4.7 times more than those with plasma cell count between 10-25%. Similarly, diffuse infiltration pattern (HR 4.67) and blastic morphology (HR 4.17) associated with a significant worse prognosis (p=0.03).
Conclusion: Comparing to laboratory-based ISS, wider HR of death spectrum in this study proposes a potential more precise, robust and easy-to-use prognostication tool.