Prognostic significance of apoptotic index in multiple myeloma patients treated by conventional therapy and novel agents, thalidomide and bortezomib.

Abstract:

OBJECTIVE:To assess the outcome of the measurement of apoptotic index in myeloma patients treated by conventional chemotherapy and novel drugs with biological mechanism of action, thalidomide and bortezomib. PATIENTS AND METHODS:In a cohort of 189 patients with newly diagnosed multiple myeloma from November 1997 through February 2008, we assessed the prognostic significance of plasma cell apoptotic index (PC-AI) using annexin-V. The whole group was subsequently divided according to treatment approach (conventional chemotherapy only vs. inclusion of novel drugs, thalidomide and bortezomib), and curves of overall survival were constructed. RESULTS:In the whole group (n = 189), low levels of PC-AI <4.5% significantly separated patients with unfavorable prognosis (median OS 16 vs. 38 months, P = 0.004). In patients treated with conventional chemotherapy only (n = 139) the results were similar (median OS 10 vs. 25 months, P = 0.02), and the apoptotic index maintained its significance even within the group of 50 patients treated also with novel drugs (median OS 30 vs. 54 months, P = 0.027). PC-AI was found to be independent on both Durie-Salmon staging system and the International Prognostic Index. CONCLUSION:Presented results suggest the use of apoptotic index by flow cytometry measurement as a fast and accessible method for prognostic stratification of myeloma patients in routine practice.

journal_name

Eur J Haematol

authors

Minarik J,Scudla V,Ordeltova M,Bacovsky J,Pika T,Langova K

doi

10.1111/j.1600-0609.2009.01321.x

subject

Has Abstract

pub_date

2009-12-01 00:00:00

pages

528-34

issue

6

eissn

0902-4441

issn

1600-0609

pii

EJH1321

journal_volume

83

pub_type

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