title: Myeloma cell morphology and morphometry in correlation with clinical stages and survival.
abstract: Multiple myeloma (MM) shows great variability in clinical course of the disease, and survival varies between a few months and more than 10 years. Myeloma plasma cells (PCs) can appear completely "normal" in morphology, but can also be overtly atypical, polymorphic, immature, as well as in all transitional forms. The aim of this investigation was to analyze the relationship between various morphological and morphometric parameters of myeloma cells, common staging/prognostic systems and survival in patients with MM. Sixty newly diagnosed MM patients were included in the study. Morphologic as well as basic morphometric features of myeloma PCs were analyzed in bone marrow (BM) aspirates, and compared with patient's clinical stage determined by Durie-Salmon and International Staging System, and with survival. We conclude that myeloma cell morphology has a prognostic potential. The most significant morphologic characteristics indicating shorter survival are: finding of >15% atypical PCs in BM aspirate, largest nuclear diameter/largest cytoplasmatic diameter of PCs ratio (maxND/maxCD)≥0.65, and anisocytosis expressed as standard deviation of maxCD ≥4.2 µm. Furthermore, PCs with irregular nuclei and absence of paranuclear clearing of the cytoplasm indicate more advanced stage of disease and worse prognosis. This preliminary results obtained on myeloma cells morphology and morphometry should be confirmed in the larger study which will include cytogenetic data as well as a therapeutic protocols applied.
authors.affiliation: Department of Cytology, Clinical Hospital Center Rijeka, Internal Medicine Clinic, Krešimirova 42, 51000, Rijeka, Croatia.
authors.forename: Irena
authors.initials: I
authors.lastname: Seili-Bekafigo
authors.forename: Toni
authors.initials: T
authors.lastname: Valković
authors.forename: Emina
authors.initials: E
authors.lastname: Babarović
authors.forename: Antica
authors.initials: A
authors.lastname: Duletić-Načinović
authors.forename: Nives
authors.initials: N
authors.lastname: Jonjić
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D048430:Cell Shape; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D009367:Neoplasm Staging; D011379:Prognosis; D016896:Treatment Outcome
keywords: clinical stages; morphometry; multiple myeloma; plasma cell morphology; survival