Prognostic significance of bone marrow histology in multiple myeloma

Abstract

BACKGROUND: Bone marrow examination continues to be the cornerstone for establishing the diagnosis of multiple myeloma in association with other clinical and laboratory parameters. Plasma cell morphology has signifi cant correlation with clinical stage and survival. AIMS: To note the bone marrow histology in detail in multiple myeloma and to correlate it with clinical stage and survival. METHODS AND MATERIAL: Fifty-fi ve cases of multiple myeloma diagnosed between January 2001 and December 2006, who had a bone marrow aspiration and biopsy done at the time of diagnosis were included in the present study. STATISTICAL ANALYSIS: SPSS software version 13.0 was used. Clinical stage and plasma cell morphology were correlated using chi square test and Spearman's correlation coeffi cient. Survival analysis was done using the Kaplan-Meier method. RESULTS: Seventy-six percent patients were in clinical stage III, 17% and 7% were in stage II and I respectively. The clinical stage correlated signifi cantly with plasma cell morphology, percentage of plasma cell infi ltration and pattern of infi ltration. Plasma cell morphology correlated signifi cantly with bone marrow parameters like percentage infi ltrate, pattern of infi ltration, degree of fi brosis and mitotic activity. Patients in advanced clinical stage, >50% plasma cells in the marrow, diffuse pattern of infi ltration, high mitosis and increased fi brosis had a shorter median survival than patients with favorable features. CONCLUSIONS: It is recommended that the bone marrow histology be studied in detail in multiple myeloma at diagnosis since it correlates well with the clinical stage and offers useful prognostic information.

Multiple Myeloma: Clinico-hematological profile in a tertiary care hospital: a three years study

“…[16] We also observed only one patient less than 40 years. The mean age of presentation was 58.38 years which is in accordance with other studies [4][5][6][7]15] whereas it is lower than that observed by Diwan G et al (62 years) [14] and Rajkumar S.V. (65 years).…”

“…Multiple myeloma (MM) is a disease predominantly of middle aged and elderly. [1] The median age of presentation in India is a decade lesser around 55 -62 years [4][5][6][7] in comparison to Western countries. [1,8] Incidence increases with age and the disease has slight male predilection.…”

Multiple Myeloma: a Retrospective Analysis of 61 Patients from a Tertiary Care Center

“…Comparable presenting complaints DOI:http://dx.doi.org/10.7314/APJCP.2016.17.4.1833 were observed by prior Pakistani and USA studies, detected fatigue and backaches in 78% and 80% respectively (Shaheen et al, 1999;Kyle et al, 2003). Bony pains and easy fatigability were also the most common symptoms in another study reported from India by Subramanian (Subramanian et al, 2009).…”

Morphological Pattern of Bone Marrow in Multiple Myeloma- A Descriptive Study

“…A study by Subramanian et al showed significant correlation between poorly differentiated plasma cell morphology and increased plasma cell burden in the marrow. 8 In our study even though cross-tabulation suggested significant relation between morphology and stage, statistical significance could not be proven due to the limited sample size of 100 cases.…”