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The relation between bone marrow angiogenesis and the proliferation index Ki-67 in multiple myeloma
  1. M G Alexandrakis1,
  2. F H Passam3,
  3. C Dambaki2,
  4. C A Pappa1,
  5. E N Stathopoulos2
  1. 1Department of Haematology, University Hospital of Heraklion, PO Box 1352, 71110, Heraklion, Crete, Greece
  2. 2Department of Pathology, University Hospital of Heraklion
  3. 3Haematology Unit, Third Department of Internal Medicine, Sotiria Hospital, Medical School of Athens, 11527 Athens, Greece
  1. Correspondence to:
 Dr M G Alexandrakis
 Department of Haematology, University Hospital of Heraklion, PO Box 1352, 71110, Heraklion, Crete, Greece;


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.

  • APAAP, alkaline–antialkaline phosphatase
  • CRP, C reactive protein
  • MM, multiple myeloma
  • MVD, microvascular density
  • PI, proliferation index
  • TBS, Tris buffered saline
  • microvascular density
  • angiogenesis
  • proliferation index
  • Ki-67
  • multiple myeloma

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