Fig. 1Intensity of CD99 immunostaining in bone marrow (A-D) and extramedullary specimens (E-H) (A and E, negative; B and F, weakly positive; C and G, moderately positive; D and H, strongly positive).
Fig. 2Kaplan-Meier survival curves in multiple myeloma patients with extramedullary biopsy (n=87) containing low CD99 expression (n=63) and high CD99 expression (n=24) (A), and bone marrow biopsy (n=136) containing low CD99 expression (n=64) and high CD99 expression (n=72) (B).
Fig. 3Kaplan-Meier survival curves in multiple myeloma patients with extramedullary biopsy (n=87) containing low CD99 expression with no autologous stem cell transplantation (ASCT) (n=40), low CD99 expression with ASCT (n=23), high CD99 expression with no ASCT (n=11), and high CD99 expression with ASCT (n=13) (A), and bone marrow biopsy (n=136) containing low CD99 expression with no ASCT (n=42), low CD99 expression with ASCT (n=22), high CD99 expression with no ASCT (n=48), and high CD99 expression with ASCT (n=24) (B). (A) 1 vs 2, p=.710; 3 vs 4, p=.004; 1 vs 3, p=.476; 2 vs 4, p=.044. (B) 1 vs 2, p<.0001; 3 vs 4, p=.028; 1 vs 3, p=.419; 2 vs 4, p=.332.
Table 1.Characteristics of multiple myeloma patients
Characteristic (n = 170) |
No. (%) |
Sex |
|
Male |
89 (52.3) |
Female |
81 (47.7) |
Morphology |
|
Plasmacytic |
121 (71.2) |
Plasmablastic |
49 (28.8) |
International Staging System |
|
Stage I |
32 (18.8) |
Stage II |
73 (42.9) |
Stage III |
58 (34.1) |
Durie-Salmon stage |
|
Stage I |
21 (12.4) |
Stage II |
46 (27.1) |
Stage IIIA |
78 (45.9) |
Stage IIIB |
25 (14.7) |
Type |
|
IgG |
84 (49.4) |
IgA |
34 (20.0) |
IgD |
7 (4.1) |
Light chain |
45 (26.5) |
Treatment |
|
No (conservative treatment) |
22 (12.9) |
Chemotherapy |
78 (45.9) |
Chemotherapy+autologous stem cell transplantation |
60 (35.3) |
Radiotherapy |
10 (5.9) |
Table 2.Characteristics of multiple myeloma patients according to CD99 expression
Characteristics |
Bone marrow biopsy (n = 136)
|
Extramedullary biopsy (n = 87)
|
CD99 low (n = 64) |
CD99 high (n = 72) |
p-value |
CD99 low (n = 63) |
CD99 high (n = 24) |
p-value |
Age (median age, 60 yr) |
|
|
.109 |
|
|
.385 |
≤ 50 |
7 (30.4) |
16 (69.6) |
|
12 (63.2) |
7 (36.8) |
|
> 50 |
57 (50.4) |
56 (49.6) |
|
51 (75) |
17 (25) |
|
Sex |
|
|
.731 |
|
|
.473 |
Male |
33 (45.2) |
40 (54.8) |
|
33 (76.7) |
10 (23.3) |
|
Female |
31 (49.2) |
32 (50.8) |
|
30 (68.2) |
14 (31.8) |
|
International Staging System |
|
|
.787 |
|
|
.072 |
Stage I |
9 (42.9) |
12 (57.1) |
|
15 (55.6) |
12 (44.4) |
|
Stage II |
24 (44.4) |
30 (55.6) |
|
36 (78.3) |
10 (21.7) |
|
Stage III |
28 (50) |
28 (50) |
|
10 (83.3) |
2 (16.7) |
|
Durie-Salmon stage |
|
|
.996 |
|
|
.792 |
Stage I |
8 (47.1) |
9 (52.9) |
|
9 (69.2) |
4 (30.8) |
|
Stage II |
17 (48.6) |
18 (51.4) |
|
18 (72) |
7 (28) |
|
Stage IIIA |
29 (46.8) |
33 (53.2) |
|
29 (70.7) |
12 (29.3) |
|
Stage IIIB |
10 (45.5) |
12 (54.5) |
|
7 (87.5) |
1 (12.5) |
|
Morphology |
|
|
.369 |
|
|
1.0 |
Plasmablastic |
20 (40.8) |
29 (59.2) |
|
14 (70) |
6 (30) |
|
Plasmacytic |
42 (50) |
42 (50) |
|
27 (73) |
10 (27) |
|
Bone lesion |
|
|
.864 |
|
|
.814 |
More than 3 lyticbone lesion |
35 (47.9) |
38 (52.1) |
|
32 (71.1) |
13 (28.9) |
|
No bone lesion |
29 (46) |
34 (54) |
|
31 (73.8) |
11 (26.2) |
|
Initial calcium (mg/dL) |
|
|
1.0 |
|
|
.478 |
≤ 12 |
60 (47.2) |
67 (52.8) |
|
62 (72.9) |
23 (27.1) |
|
> 12 |
4 (44.4) |
5 (55.6) |
|
1 (50) |
1 (50) |
|
Urine protein (g/day) |
|
|
.203 |
|
|
.568 |
< 4 |
42 (46.2) |
49 53.8) |
|
50 (72.5) |
19 (27.5) |
|
≥ 4 and ≤ 12 |
11 (55) |
9 (45) |
|
5 (71.4) |
2 (28.6) |
|
> 12 |
0 (0) |
2 (100) |
|
3 (100) |
0 (0) |
|
Hemoglobin (g/dL) |
|
|
.374 |
|
|
.117 |
< 8.5 |
20 (57.1) |
15 (42.9) |
|
9 (100) |
0 (0) |
|
≥ 8.5 and ≤ 10 |
15 (51.7) |
14 (48.3) |
|
6 (60) |
4 (40) |
|
> 10 |
27 (42.9) |
36 (57.1) |
|
40 (71.4) |
16 (28.6) |
|
Table 3.Multivariate survival analyses of multiple myeloma patients with extramedullary biopsy (n=87)
Factor |
Unfavorable factor |
Odds ratio |
95% Confidence interval |
p-value |
Age |
> 50 |
1.408 |
0.566–3.506 |
.462 |
Sex |
Male |
1.695 |
0.807–3.559 |
.163 |
International Staging System stage |
II |
7.787 |
1.148–52.820 |
.036 |
|
III |
14.714 |
1.931–112.097 |
.009 |
Durie-Salmon stage |
IIIB |
0.554 |
0.048–6.430 |
.637 |
Morphology |
Plasmablastic |
1.495 |
0.671–3.331 |
.326 |
CD99 expression (extramedullary specimen) |
Low expression |
1.073 |
0.478–2.410 |
.864 |