title: The association between COX-2 expression and survival in myeloma patients.
abstract: BACKGROUND
  Increased cyclooxygenase-2 (COX-2) expression has been associated with poor prognosis in multiple myeloma (MM).
  
  
  OBJECTIVE
  This study examined the relationship between COX-2 expression in bone marrow and prognosis in MM patients.
  
  
  METHODS
  Bone marrow biopsy samples of 67 newly diagnosed MM patients were examined immunohistochemically for COX-2 expression. Mean age of the patients was 52.69 years (52.69 ± 9.17) and median follow-up time was 99.5 months (range: 6-170 months).
  
  
  RESULTS
  Of all patients, 30 (44.8%) were COX-2 positive and 37 (55.2%) were COX-2 negative. Median overall survival (OS) was 78 months (range: 54.07-101.92 months) among all patients, 75 months (range: 45.61-104.38 months) in COX-2-positive patients, and 98 months (range: 50.36-145.63 months) in COX-2-negative patients. Median progression-free survival (PFS) was 30 months (range: 3-134 months) in all, 29.5 months (range: 3-68 months) in COX-2-positive and 35 months (range: 3-134 months) in COX-2-negative patients. Statistically significant differences in OS and PFS between COX-2-positive and COX-2-negative patients were not observed (p = 0.84 and p = 0.22, respectively). Differences between the COX-2-positive and COX-2-negative patients in gender, hemoglobin, β2-microglobulin (β2M), creatinine, albumin, and disease stage were not statistically significant.
  
  
  CONCLUSIONS
  COX-2 expression neither had a role in prognosis nor significantly affected OS and PFS. We conclude that stem cell transplantation might eliminate the detrimental effects of COX-2 positivity. Larger series of patients are needed to investigate this observation.
authors: Department of Hematology, Department of Pathology1, Medical Faculty, Ege University, Izmir, Turkey. fivural@yahoo.com.
authors: F
authors: F
authors: Vural
authors: N
authors: N
authors: Soyer
authors: M
authors: M
authors: Hekimgil
authors: S
authors: S
authors: Cagirgan
authors: A
authors: A
authors: Donmez
authors: M
authors: M
authors: Tombuloglu
mesh_terms: D001853:Bone Marrow / Q000378:metabolism; D051546:Cyclooxygenase 2 / Q000378:metabolism*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000378:metabolism* / Q000401:mortality*; D011379:Prognosis
chemical_list: D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human