DNA-image cytometry and clinical staging systems in multiple myeloma.
Clinical and hematological parameters, and three derived major staging systems were compared with DNA-cytometric parameters in 73 patients with newly diagnosed multiple myeloma (MM) and correlated in univariate analysis with survival to assess their predictive value. Regarding diagnostic validity, a multi-parameter system including STL, 5cER, PRF and MNA correctly classified 92% of MM as malignant (sensitivity 92%) at a 100% specificity. Regarding prognosis, the most powerful single clinical parameter was serum creatinine (p < 0.001, median survival [ms] 51 vs. 14 months) followed by platelet count (p < 0.01, ms 67 vs. 11 months). Mean nuclear area of plasma cells was the only cytometric parameter with prognostic relevance (p < 0.05, ms 43 vs. 14 months). Neither the original Salmon-Durie staging (p < 0.05 for I vs. II, p > 0.05 for II vs. III) nor the revised Salmon-Durie staging by Cavo et al were able to discriminate three patient groups at statistically significant levels. Only the staging system proposed by the British Medical Research Council (MRC) was found to be able to predict survival for all three groups significantly (p = 0.01 for A vs. B, p < 0.01 for B vs. C; ms A/B/C = 68/37/14 months, respectively).
Department of Hematology/Oncology (Innere Medizin A), Westfälische- Wilhelms-Universität Münster, Germany.
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M
Kropff
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Leo
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Steinfurth
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Esselborn
C P
CP
Adler
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A
Böcking
D000704:Analysis of Variance; D001853:Bone Marrow / Q000473:pathology; D003592:Cytophotometry; D004273:DNA, Neoplasm / Q000032:analysis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000235:genetics* / Q000401:mortality / Q000473:pathology*; D009367:Neoplasm Staging / Q000379:methods; D010265:Paraproteinemias / Q000473:pathology; D011003:Ploidies; D011379:Prognosis; D012680:Sensitivity and Specificity; D016019:Survival Analysis
D004273:DNA, Neoplasm