Haematologica 2003 - Supplements

143
Evaluation of Bone Marrow Angiogenesis in newly
diagnosed myeloma patients before and after treatment
with the combination VAD containing liposomal
doxorubicin plus Thalidomide.
E. Hatjiharissi1, M. Papaioannou1, V. Kaloutsi2, C.
Hatjileontis2, N.Eleftheriadis1, C. Tsimirika1, M.A.
Dimopoulos,3 J. Christakis1, K. Zervas1
1Department of Hematology-Oncology, Theagenion Cancer
Center, Thessaloniki, Greece; 2Department of Pathology, Aristotle
University of Thessaloniki, Thessaloniki, Greece; 3Department of
Clinical Therapeutics and Internal Medicine, University of Athens,
School of Medicine, Athens
Background Bone marrow angiogenesis (BMA) is increased in
Multiple Myeloma (MM) and its extent is considered as an
important prognostic factor. However, the impact of treatment in
BMA is still controversial. Aim of study. The purpose of this
study was to evaluate in newly diagnosed myeloma patients the
changes in BMA after treatment with combination VAD
containing liposomal doxorubicin plus Thalidomide. Patients
Nineteen consecutive myeloma patients, (12 females, 7 males)
with median age 67 years (range 47-76) were included into the
study. The patients were treated with liposomal doxorubicin
(40mg/m2) day 1, vincristine (2mg) day 1, dexamethasone (40
mg d 1-4) orally, every 4 weeks. Thalidomide was given daily at
the dose of 200mg. Patients were reevaluated for response after
four cycles of treatment. Methods. We studied BMA in bone
marrow biopsy specimens at diagnosis and after the fourth cycle
of treatment. Angiogenesis was estimated by microvessel density
(MVD) using standard immunohistochemical staining for CD 34
MoAb. Microvessels were counted in the whole cellular bone
marrow at 400x magnification. MVD was expressed as number of
vessels per mm2. Angiogenesis was also estimated in a control
group of 10 normal bone marrow biopsies. MVD values in
patients were compared using paired t-test. Cox regression
analysis was used to evaluate the prognostic significance of
pretreatment MVD, and known prognostic factors such as serum
beta-2 microglobulin, C-reactive protein, albumin and LDH.
Results: Sixteen out of nineteen patients (84%) achieved
objective response and three had progressive disease. Median
MVD in controls was 3.06 (range 2.3-3.8) and the mean value
was 3.1 ± 0,6. The pretreatment median MVD in patients was
19.02 (range13.5-28.9), mean 19,85 ± 4,96. After four cycles of
treatment the median and mean MVD were 12,9 (range7,9-21,6)
and 13,5 ± 4,7 respectively. There was significant difference in
MVD between controls and patients at diagnosis (p