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  • 1
    ISSN: 1432-0584
    Keywords: Key words Multiple myeloma ; Prognostic factor ; Morphology ; Elderly ; Young
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The prognostic value of morphological classifications and clinical variables was compared between 31 elderly (≥65 years) and 43 young (〈65 years) patients with myeloma. Prognostic factors were divided into three groups: factors useful in elderly patients, e.g., calcium, albumin; factors useful in young patients, e.g., platelet, creatinine, light-chain type; and factors useful in both patients, e.g., clinical stage, hemoglobin, LDH, CRP, bone marrow plasma cell and plasmablast percentages, light- and electron-microscopic classifications. The 5-year survival rates of elderly patients with calcium 〈12 and ≥12 mg/dl were 66.2 and 〈11.1%, respectively (p〈0.01). Those of the young patients were 64.1 and 33.3%, respectively. The 5-year survival rates of elderly patients with platelets ≥200×109/l and 〈100×109/l were 59.7 and 50.0%, respectively. Those of the young patients were 68.9 and 33.3%, respectively (p〈0.05). The 5-year survival rates of elderly patients with few and numerous electron-microscopic abnormalities were 90 and 0%, respectively (p〈0.01), those of young patients were 92.9 and 〈14.3%, respectively (p〈0.01). These findings suggest that individual clinical variables may differ in prognostic importance in elderly and young patients.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0584
    Keywords: Key words Multiple myeloma ; Ultrastructure ; Prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Myeloma cells were ultrastructurally analyzed in relation to survival in 54 patients with myeloma who were treated with melphalan-prednisolone or cyclophosphamide-prednisolone. Since previous studies by electron microscope had demonstrated that the degree of nuclear-cytoplasmic asynchrony of myeloma cells was associated with poor prognosis, this study focused on three kinds of nuclear abnormalities and eight kinds of cytoplasmic abnormalities. The patients were classified into three groups according to the presence of these abnormalities. The median survival times of the first group with five or fewer of 11 different kinds of abnormalities, the second group with 6–8 abnormalities, and the third group with nine or more abnormalities were 2353, 531, and 115 days, respectively. Furthermore, this classification by ultrastructural abnormalities corresponded to those by the initial hemoglobin concentrations, platelet counts, and percentages of myeloma cells and plasmablasts in the bone marrow. These findings suggest that ultrastructural analysis of nuclear and cytoplasmic abnormalities, in addition to nuclear maturity, of myeloma cells may provide important information for predicting the prognosis in myeloma patients.
    Type of Medium: Electronic Resource
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