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Diffuse MRI marrow pattern correlates with increased angiogenesis, advanced disease features and poor prognosis in newly diagnosed myeloma treated with novel agents

Leukemia volume 24, pages 1206–1212 (2010)Cite this article

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Multiple myeloma (MM) is a relatively common hematological malignancy characterized by the presence of lytic bone disease.1 As part of the staging procedures of newly diagnosed myeloma, the skeletal survey is mandatory, while bone marrow magnetic resonance imaging (MRI) can give complementary information and is recommended for patients with normal conventional radiographs.2 MRI is very sensitive in detecting bone marrow involvement.3 Four MRI patterns of marrow involvement in myeloma have been recognized: (1) normal appearance of bone marrow despite minor microscopic plasma cell infiltration, (2) focal involvement, (3) diffuse involvement and (4) ‘salt-and-pepper’ pattern with innumerable small focal lesions (variegated pattern).3, 4, 5 MRI pattern of bone marrow involvement correlated with prognosis in patients with MM who received conventional therapies.3, 4, 5 However, there are limited data on the prognostic role of MRI pattern of marrow involvement in myeloma patients who receive novel therapies, such as bortezomib or the immunomodulatory drugs (IMiDs) thalidomide and lenalidomide.

Increased angiogenesis is implicated in the pathogenesis of both myeloma cell growth and myeloma bone disease. The microvessel density (MVD) in bone marrow trephine biopsies correlates with survival in myeloma patients.6 The aim of this study was to evaluate the prognostic value of MRI pattern of marrow infiltration in newly diagnosed myeloma patients who receive novel agents and to explore possible correlations of MRI pattern with clinical and laboratory data, bone marrow angiogenesis, lytic bone disease and survival.

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Authors and Affiliations

  1. Department of Radiology, University of Athens, School of Medicine, Areteion Hospital, Athens, Greece

    L A Moulopoulos & A Koureas

  2. Department of Clinical Therapeutics, University of Athens, School of Medicine, Alexandra General Hospital, Athens, Greece

    M A Dimopoulos, D Christoulas, E Kastritis, M Roussou, M Gavriatopoulou, M Migkou, M Iakovaki, M Gkotzamanidou & E Terpos

  3. Department of Hematopathology, Evangelismos General Hospital, Athens, Greece

    D Anagnostou & A Tasidou

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  1. L A Moulopoulos
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  2. M A Dimopoulos
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Correspondence to L A Moulopoulos.

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Moulopoulos, L., Dimopoulos, M., Christoulas, D. et al. Diffuse MRI marrow pattern correlates with increased angiogenesis, advanced disease features and poor prognosis in newly diagnosed myeloma treated with novel agents. Leukemia 24, 1206–1212 (2010). https://doi.org/10.1038/leu.2010.70

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