title: Bone marrow microvessel density and its prognostic significance in AML.
abstract: Microvessel density reportedly is increased in various hematologic disorders including acute lymphatic and myeloid leukemias. In these patients the bone marrow microvessel density (BM-MVD) appears to be associated with an unfavorable prognosis. In the present study, we have retrospectively analyzed the BM-MVD (at diagnosis) in 31 patients with acute myeloid leukemia (AML) (median age: 38 years; range: 21-53 years; f:m-ratio: 1:1,4) who underwent conventional chemotherapy and consecutive allogeneic bone marrow transplantation (BMT). The median BM-MVD at diagnosis was 30/mm2 (range: 17-48/mm2) and thus was significantly higher compared to controls (n = 9; BM-MVD: median 7/mm2, range 2-11/mm2; P < 0.05). In patients who failed to achieve a complete remission (CR) in response to induction chemotherapy, the BM-MVD was significantly higher (median: 41.5/mm2) at diagnosis than in patients who entered CR (median: 28.5/mm2, P < 0.05). In addition, patients with high BM-MVD ( > 30 mm2) had a significantly shorter overall survival compared to patients with a lower BM-MVD ( < 30 mm2, P < 0.05). Moreover, patients with a high BM-MVD ( > 30 mm2) were found to have a significantly higher risk of relapse (P < 0.05). In 4 patients in whom a continuous complete remission was documented after BMT, the BM-MVD levels were analyzed at diagnosis as well as between day + 80 and day + 100 after BMT. In all 4 patients, the BM-MVD was found to decrease in response to BMT until day 100 (P < 0.05). Together, our data suggest that the BM-MVD could be a prognostic parameter concerning survival in patients with AML undergoing allogeneic BMT.
authors.affiliation: Department of Internal Medicine I, Vienna, Austria. werner.rabitsch@akh-wien.ac.at
authors.forename: Werner
authors.initials: W
authors.lastname: Rabitsch
authors.forename: Wolfgang R
authors.initials: WR
authors.lastname: Sperr
authors.forename: Klaus
authors.initials: K
authors.lastname: Lechner
authors.forename: Andreas
authors.initials: A
authors.lastname: Chott
authors.forename: Erika
authors.initials: E
authors.lastname: Prinz
authors.forename: Peter
authors.initials: P
authors.lastname: Valent
authors.forename: Peter
authors.initials: P
authors.lastname: Kalhs
mesh_terms: D000208:Acute Disease; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001853:Bone Marrow / Q000098:blood supply*; D016026:Bone Marrow Transplantation; D002196:Capillaries / Q000648:ultrastructure; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007951:Leukemia, Myeloid / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D016019:Survival Analysis; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014699:Venules / Q000648:ultrastructure