[The prognostic significance of cytological study of the bone marrow in multiple myeloma].
OBJECTIVE
To show that the activity of a multiple myeloma (MM) course, its sensitivity to chemotherapy and prognosis correlate with maturity of medullary plasma cells (MPC).


METHODS
Bone marrow films from 88 primary MM patients. The films were stained by Romanovsky-Giemsa and studied by the immersion objective. Four types of MPC maturity by Ph. Greipp et al. classification were identified: mature (n = 5), intermediate (n = 55), immature (n = 26) and plasmoblastic type (n = 2).


RESULTS
The survival median in MM patients with immature MPC type was 18 months, with intermediate type--46 months (p < 0.05). Anemia was registered in 73 and 51% of the patients, respectively (p < 0.05). The average amount of MPC was 51 and 30%, respectively (p < 0.05). The percentage of MPC does not always correlate with the tumor mass in MM. To make a more accurate MM diagnosis it is valid to make additional histological investigations of the bone marrow. With transition of the stable MM phase into the aggressive one bone marrow comprises more immature MPC and plasmoblasts.


CONCLUSIONS
MM patients with immature and plasmoblastic type of MPC belong to the group of high risk and should receive combined and intensive polychemotherapy immediately after the diagnosis.
Iakovleva
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SV
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology*; D001856:Bone Marrow Examination / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000145:classification / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D011379:Prognosis; D018709:Statistics, Nonparametric