ORIGINAL ARTICLE

The relation between bone marrow angiogenesis and the proliferation index Ki-67 in multiple myeloma

M G Alexandrakis¹, F H Passam³, C Dambaki², C A Pappa¹, E N Stathopoulos²

¹ Department of Haematology, University Hospital of Heraklion, PO Box 1352, 71110, Heraklion, Crete, Greece
² Department of Pathology, University Hospital of Heraklion
³ Haematology Unit, Third Department of Internal Medicine, Sotiria Hospital, Medical School of Athens, 11527 Athens, Greece

Correspondence to:
Correspondence to:
Dr M G Alexandrakis
Department of Haematology, University Hospital of Heraklion, PO Box 1352, 71110, Heraklion, Crete, Greece; freda{at}med.uoc.gr

Aim: Angiogenesis correlates with disease progression in various haematological malignancies. This study investigated the association between microvascular density (MVD) and the Ki-67 proliferation index (Ki-67 PI), bone marrow infiltration, and C reactive protein (CRP) in patients with multiple myeloma.

Methods: Bone marrow MVD was examined in 44 biopsies at diagnosis and 15 in plateau phase by immunostaining the endothelial cells with a monoclonal antibody to CD34. The Ki-67 PI was evaluated by a double immunostaining technique using the monoclonal antibodies MIB-1 and CD38.

Results: MVD, Ki-67 PI, bone marrow infiltration, and CRP were significantly higher in pretreatment patients than in controls and decreased in patients achieving plateau phase. MVD significantly correlated with Ki-67 PI and infiltration, and Ki-67 correlated with infiltration.

Conclusion: In multiple myeloma, apart from being a marker of proliferative activity, Ki-67 is also associated with bone marrow angiogenesis and tumour burden.

Abbreviations: APAAP, alkaline–antialkaline phosphatase; CRP, Creactive protein; MM, multiple myeloma; MVD, microvascular density; PI, proliferation index; TBS, Tris buffered saline

Keywords: microvascular density; angiogenesis; proliferation index; Ki-67; multiple myeloma

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