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The immunological significance of cellular infiltrates in chronic rejection of human kidney transplants.

Fifteen transplanted human kidneys with clinical and histological signs of chronic rejection were examined microscopically for cellular infiltration. Three normal kidneys were used as a reference. All infiltrating cells were classified and counted. The average number of cells per 10 microscopic fields was called the relative density of cellular infiltrates. Differences in the densities of different cell classes and changes in the cellular infiltration of the grafts were regarded as cellular expressions of the immune response. Summarizing our results, we conclude that: 1) the chronic immunological rejection of transplanted human kidneys is essentially caused by immunocompetent cells; 2) plasma cells develop in the graft itself; 3) the immunocompetent cell population tends to be purely and simply made up of plasma cells; 4) therefore, the true "effector cell" among the immunocompetent cells may be the plasma cell--at least in the chronic rejection of transplanted human kidneys. Cleaved lymphocytes were the most frequent of the infiltrating cells found in the transplants. However, their role is not yet clear.

Cell Count↗

The vascular response to tumor infiltration in malignant gliomas. Morphometric and reconstruction study.

Neo-vascularization and endothelial hyperplasia have been shown to be very active in malignant gliomas. In this contribution the vascularization of the cortex infiltrated by malignant gliomas is morphometrically studied and the endothelial proliferations are immunohistochemically investigated and reconstructed by a three-dimensional computer-assisted procedure. Vessel density increases after tumor infiltration in some cases only. The diameter of vessels increases and so does the number of nuclei/vessel after the complete invasion of the cortex when vascular glomeruli develop. In completely infiltrated cortex with development of glomeruli and circumscribed necroses, vessel density is very low. No neoformation of vessels takes place before the complete infiltration of the cortex by the tumor. The hyperplastic formations, usually arranged parallel to the deep or outer cortical layers, take origin from the radially penetrating vessels from the meninges and their lateral branching. The hyperplasia deforms the vascular network, making it often inadequate to supply tumor cells. Immunohistochemically, the cells composing the hyperplastic structures are variably positive for factor VIII/RAg and, at a lesser extent, for alpha-smooth muscle actin. The poorness of the vascular network in many instances of completely infiltrated cortex is responsible for the development of circumscribed necroses.

Brain Neoplasms↗

Glomerular monocyte infiltration in human nephropathies: prevalence and correlation with clinical and morphological variables.

Glomerular monocyte infiltration was evaluated by histochemical means (nonspecific esterase) and/or electron microscopy in 305 renal biopsies belonging to a wide variety of human renal diseases. Significant monocyte infiltration was never observed in a first group of nepropathies (minimal change disease, nephrotic syndrome with IgM deposits, focal segmental glomerulosclerosis, membranous GN, Berger's GN, healed GN, dense deposit disease, chronic non specific GN, benign familial haematuria, Alport's disease, renal amyloidosis, arteriosclerotic kidney, light chain GN). Conversely, it was present at varying frequency in a second group of nephropathies including: acute GN (58.3%), persistent GN (10%), membranoproliferative GN (25.2%), eryoglobulinaemic GN (82.6%), lupus GN (36%), extracapillary proliferative GN (50%) and Schoenlein-Henoch GN (40%). The results indicate: 1) there is an evident association between monocyte infiltration and the subendothelial site of deposits; 2) the presence of monocytes is not affected by the size and extension of subendothelial deposits; 3) monocytes were more frequently observed when IgG, IgM and fibrinogen were present in the subendothelial deposits, Conversely, complement fractions do not seem to affect monocytic activity; 4) polymorphonuclear leukocyte exudation is less frequently found and mostly associated with monocyte infiltration; 5) in some GNs (persistent GN, cryoglobulinaemic GN and membranoproliferative GN), proteinuria was significantly higher in patients with than in those without monocyte infiltration, giving support to the hypothesis that in human beings as in experimental animals monocytes play a role in the pathogenesis of proteinuria.

Biopsy↗

Inhibition of inflammatory cell infiltration by bicyclic imidazoles, SK&F 86002 and SK&F 104493.

The mode of action of the dual inhibitors of eicosanoid metabolism, SK&F 86002 and SK&F 104493 was evaluated on inflammatory cell infiltration induced in mice by carrageenan, monosodium urate crystals, and arachidonic acid. The results were compared to those seen with standard antiinflammatory compounds. Inflammatory cell infiltration was inhibited by SK&F 86002. SK&F 104493, colchicine, and phenidone but not naproxen. In vivo, PMN infiltration induced by LTB4 was inhibited by colchicine but not by SK&F 86002, SK&F 104493, or phenidone treatment. Similarly, in vitro chemotaxis to LTB4 was not inhibited by SK&F 86002. The 5-lipoxygenase inhibitors, SK&F 86002, SK&F 104493, and phenidone inhibited LTB4 production in vivo as well as inflammatory cell infiltration induced by arachidonic acid. The data are consistent with the suggestion that the bicyclic imidazoles inhibit PMN infiltration by virtue of inhibition of LTB4 production.

Animals↗

Downward regulation of neutrophil infiltration by endogenous histamine without affecting vascular permeability responses in air-pouch-type carrageenin inflammation in rats.

The role of histamine in neutrophil infiltration and vascular permeability response in carrageenin air pouch inflammation in rats was examined. Injection of carrageenin solution into an air pouch induced a gradual increase in histamine content in the pouch fluid and histidine decarboxylase activity of pouch wall tissues, with a maximum attained at 24 h. Local administration of the H2 antagonists cimetidine and famotidine, but not the H1 antagonist pyrilamine, induced an increase in neutrophil infiltration at 24 h. Both types of histamine antagonists failed to suppress the vascular permeability response. In addition, H2 antagonists attenuated the inhibitory effect of indomethacin on neutrophil infiltration without affecting the indomethacin-induced suppression of vascular permeability response. These results suggest that histamine produced in the inflammatory locus exerts a downward regulation of neutrophil infiltration through H2 receptors but does not play any significant role in the vascular permeability response. Furthermore, the inhibition by indomethacin of neutrophil infiltration might be ascribed to the increase in histamine level in the pouch fluid.

Anaphylaxis↗

Eosinophil infiltration and degranulation in Helicobacter pylori-associated chronic gastritis.

Eosinophil granules contain cationic proteins, including the major basic protein, which are toxic to mammalian tissue. While eosinophils have been observed to comprise part of the inflammatory reaction in acute Helicobacter pylori gastritis, the role of the eosinophil in the pathogenesis of chronic gastritis is unknown. We evaluated whether eosinophil infiltration and degranulation are associated with chronic gastritis and H. pylori infection. We studied eight patients with chronic H. pylori antral gastritis, three with chronic antral gastritis in the absence of H. pylori, 11 healthy age-matched volunteers without antral gastritis, and eight patients with H. pylori-negative chronic specific gastritis (three Crohn's antral gastritis and five Ménétrier's disease). Serial sections were stained with hematoxylin and eosin, with Giemsa, and by a specific indirect immunofluorescence technique for eosinophil granule major basic protein. Specimens were graded independently by three observers and scores of 0-3 were given for eosinophil infiltration and degranulation (0 = none to 3 = confluent infiltration and/or degranulation). In H. pylori antral gastritis, significantly greater eosinophil infiltration and degranulation were found compared to the normal group, Ménétrier's disease, and chronic H. pylori-negative gastritis. There was no significant difference between gastric Crohn's disease and H. pylori gastritis. The severity of chronic gastritis was significantly correlated with the eosinophil score. Eosinophil degranulation did not appear to be greater at or near sites of bacterial colonization in the H. pylori gastritis specimens. The results suggest that eosinophil infiltration and degranulation may be associated with H. pylori gastritis. We postulate that the release of toxic cationic proteins from eosinophils contributes to the inflammatory changes present in H. pylori gastritis.

Cell Degranulation↗

Macrophage and dendritic cell infiltration in head and neck squamous-cell carcinoma; an immunohistochemical study.

A study was undertaken to help us reach a better understanding of the tumor-infiltrating pattern of lymphoid cells and in particular of monocyte-derived cells, namely the CD68+, acid-phosphatase-expressing scavenger macrophages and the MHC-class-II- and S100-antigen-presenting dendritic cells in head and neck squamous-cell carcinoma. In the stroma of the tumors distinctive small fields of lymphocytes were found, the T cell areas of these fields being intermingled with dendritic cells. Intra-epithelial dendritic cell infiltration was low. The infiltrative pattern of macrophages was similar to patterns described in earlier studies with substantial stromal invasion and inconsistent intra-epithelial invasion, but small granuloma-like structures of CD68+ macrophage-like cells, found in the stroma of tumors, have not been reported before. The histochemical localization of the tumor-infiltrated dendritic cells and macrophages supports the view that the former cells are involved in the sensitization to tumor antigens, whereas the latter cells are involved in tumor cytotoxicity/scavenging of tumor cell debris. Although it has been shown in the past that transmembranal (TM) factors (p15E-like factors) present in the serum and tumor of patients with cancer of the head and neck have suppressive effects on monocyte/macrophage/dendritic cell function, a relationship between the intensity of epithelial staining for TM factors and the infiltrative pattern of monocytes/macrophages/dendritic cells could not be demonstrated.

Antigens, CD↗

Is the i.v. obstructed or infiltrated? A simple clinical test.

OBJECTIVE: The objective of our study was to determine if clinical observation of pressure-flow relationships (PFR) can differentiate between partial external obstruction (obstruction) and infiltration as a cause of poor performance of gravity-fed infusions. METHODS: A total of 24 patients with functional intravenous cannulae in situ had obstruction simulated by the application of a tourniquet proximal to the cannula. The change in flow (delta F) for a discrete change in pressure (delta P) was determined in each case by counting drop rates at two different elevations of the fluid reservoir level, 10 cm apart. The same process was repeated in 15 patients in whom the cannula was in an extra vascular location (infiltration). Three sizes of cannula--16-gauge, 18-gauge, and 20-gauge--were examined, with equal distribution of sizes in each group. The effect on flow rates of inflating a blood pressure (BP) cuff proximally on the cannulated limb was assessed. The ratio delta P/delta F is the total resistance of the infusion system, and by subtracting known values for resistance of infusion tubing and cannula, the venous or tissue resistance was calculated. RESULTS: There was a statistically significant difference between the change in flow for obstructed compared with infiltrated cannulae for the same change in pressure for each cannula size. The mean venous resistance was 23 mm Hg/L/hr, while that of tissue was 280 mm Hg/L/hr, with no overlap between groups. There was no effect on flow rate with blood pressure cuff inflation in the infiltrated group whereas flow progressively fell in the obstructed group. CONCLUSIONS: Clinical observation of PFRs in poorly functioning gravity-fed IV infusions can assist in detecting infiltration as a cause. Inflation of a blood pressure cuff will further impair flow where the cannula is intravascular, but will have no effect in an extravascular location.

Blood Pressure Determination↗

Sectorial corneal infiltrates and pannus in herpes zoster ophthalmicus.

We report four patients with herpes zoster ophthalmicus who developed a dense pannus limited to a sector of the superior cornea that advanced to the central region of the cornea. The pannus appeared to develop in response to peripheral infiltrates in a subepithelial or anterior stromal location and not in association with disciform corneal edema, interstitial keratitis, or scleritis. The corneal pannus developed insidiously as a late complication without associated ulceration and with little or no anterior uveitis or conjunctival reaction. Additionally, all four patients developed anterior and mid-stromal infiltrates in a punctate or incomplete ring configuration at the leading border of the pannus that threatened the visual axis. In the three patients that were treated with topical corticosteroids, the infiltrates resolved with preservation of visual acuity. The other patient developed central scarring with a permanent reduction in vision. Patients with infiltrates and pannus in a sector of the cornea should be followed carefully and treated with topical corticosteroids when infiltrates appear to prevent progression to the central cornea.

Adolescent↗

Endoscopic evaluation of gastric cancer infiltrating the lower esophagus.

Endoscopic and histopathological findings were compared in 74 patients with gastric cancer infiltrating the lower esophagus who had undergone gastrectomy to evaluate mode of esophageal infiltration. There were no early cancers. Cancer infiltration modes were histopathologically broken down into three types: superficial, whole layer, and deep layer. Endoscopic findings were broken down into five types for proximal infiltration. Endoscopy used for histological evaluation frequently revealed the protruded type to be whole layer and had a highly accurate diagnosis rate (94%); it revealed the histology of the other four types to be primarily superficial. Extent of cancer invasion was underestimated in giant-rugae tumors (40%), as endoscopy could barely detect the small nest of esophageal infiltrations. Lugol staining was useful in preventing underestimation. For flat cancer, which is poorly demarcated and is often accompanied by vascular invasion, preoperative evaluation is very difficult, requiring preoperative examination of a frozen section taken from the proximal edge of resected specimen.

Adenocarcinoma↗

Time course of ICAM-1 expression and leukocyte subset infiltration in rat forebrain ischemia.

The time course of ICAM-1 expression and leukocyte subset infiltration was studied in a model of CNS reperfusion injury in adult rats. Leukocyte adhesion and infiltration, mediated in part by intercellular adhesion molecule-1 (ICAM-1), appears to potentiate CNS reperfusion injury. The timing and relationship between ICAM-1 staining and leukocyte infiltration postglobal CNS ischemia is unknown. Reversible forebrain ischemia was produced in 32 adult Sprague-Dawley rats using the two-vessel occlusion model with histologic analysis performed at specific intervals postischemia: 1, 3, 6, 12, and 24 h, 4 and 7 d, or sham-operated controls (n = 4 each group). Monoclonal antibodies against ICAM-1 (1A29 and TM8), a specific granulocyte (PMN) (HIS48), and a specific monocyte/macrophage (M phi) (ED1) were used. No specific leukocyte and only rare ICAM-1 vessel immunoreactivity was observed in sham controls. ICAM-1: Significant expression in microvessels beginning at 1 h with additional diffuse CA1 pyramidal layer staining beginning at 4 d. Leukocytes: No PMN cells and rare M phi identified at 6 and 12 h. By 24 h: moderate infiltrate in areas of ICAM-1 expression of PMN and M phi. At 4 and 7 d: only M phi accumulation, cellular morphology now similar to microglia. The results of this study indicate that early and persistent ICAM-1 expression occurs following CNS ischemia with associated leukocyte infiltration.

Animals↗

Wound infiltration with lidocaine prolongs postoperative analgesia after haemorrhoidectomy with spinal anaesthesia.

PURPOSE: There are few clinical data examining whether sensitization of peripheral nerves contributes to postoperative pain when the entry of noxious impulses to the central nervous system is blocked. We hypothesized that wound infiltration with lidocaine would provide better postoperative analgesia than with normal saline following haemorrhoidectomy with spinal blockade. METHODS: In a randomized, placebo-controlled, blinded study, 168 adults undergoing haemorrhoidectomy were allocated to two groups. In Group L (n = 88) local infiltration was provided with lidocaine 1% and in Group S (n = 80) with normal saline. Following spinal anaesthesia with lidocaine 3%, the surgeon infiltrated 15 ml of either infiltration solution to the surgical area. Postoperative analgesia was obtained by continuous epidural administration of 90 mg eptazocine in normal saline for 48 hr. Supplemental analgesics were given on request. Postoperative pain control was assessed at rest and during coughing with a 10 cm VAS on the 1st, 2nd, and 3rd postoperative days (POD). RESULTS: The VAS scores at rest in Group L were lower than those in Group S throughout the postoperative period. During coughing, VAS scores in Group S were increased on the 3rd postoperative day, while those in Group L remained constant (4.42 +/- 0.27 vs 3.14 +/- 0.28, P < 0.05). Fewer patients in Group L than in Group S required supplemental analgesics. CONCLUSION: Preoperative lidocaine infiltration to the surgical area provided prolonged postoperative analgesia in patients receiving haemorrhoidectomy with spinal anaesthesia.

Adult↗

Quantitative temporal analysis of pancreatic islet T lymphocyte and macrophage infiltration heralded by serum IgE in congenic BioBreeding (BB) Gimap5-/- rats at risk for insulitis and acute onset diabetes.

OBJECTIVE AND DESIGN: The objective was to determine the association between serum IgE levels and the infiltration order of T lymphocytes and macrophages in pancreatic islets in relation to the loss of insulin and glucagon cells in presymptomatic congenic BB Gimap5-DP (Diabetes Prone) rats. MATERIAL: Congenic prediabetes BB Gimap5-DP and control Gimap5-DR (Diabetes Resistant) rats were followed every other day from 29 to 32&#xa0;days of age until peak serum IgE (&#x2264;&#x2009;55&#xa0;days of age). METHODS: Serum IgE was measured using ELISA. The HALO&#x2122; platform facilitated quantitative image analysis of infiltrating T lymphocytes, macrophages, and target organ insulin and glucagon cells. Whole genome sequencing (WGS) was employed to identify candidate type 1 diabetes genes. RESULTS: Serum IgE levels increased with age in normoglycemic BB Gimap5-DP rats. Quantification of infiltrating cells per mm2 in and around the islets indicated that T lymphocytes are the initial infiltrators, followed by macrophages. Elevated serum IgE levels inversely correlated with beta-cell mass (total mg insulin/mg pancreas). WGS refined the risk segment for islet inflammation to 1.02 Mbp, leaving 10 candidate genes, including Gimap4 and Gimap5. CONCLUSIONS: Elevated IgE levels herald T lymphocyte and macrophage infiltration. Pancreatic islet inflammation was linked to Gimap4, Gimap5, and other potential candidate genes on rat chromosome 4.

Animals↗

IL-8 is involved in homologous TNF alpha-, but not in IL-1 beta-induced neutrophil infiltration in rabbits.

OBJECTIVE AND DESIGN: We examined the involvement of IL-8 in TNF alpha and IL-1 beta neutrophil infiltration, using homologous reagents. SUBJECTS: Female New Zealand white rabbits (n = 211). METHODS: After injection of TNF alpha (1 microgram) or rrIL-1 beta (300 pg) into rabbit knee joints, the leukocyte influx and the production of IL-8 were estimated. Anti-TNF alpha mAb, rrIL-1Ra, and anti-IL-8 IgG (10 micrograms each) were administrated simultaneously with either TNF alpha or IL-1 beta. RESULTS: Administration of TNF alpha or IL-1 beta induced IL-8 production; both of which peaked at 1 h after the injection. Maximum neutrophil infiltration induced by TNF alpha was inhibited by 38-56% by anti-IL-8 IgG, 22-43% by rrIL-1Ra, and 77-83% by anti-IL-8 IgG plus rrIL-1Ra. In contrast, maximum neutrophil infiltration induced by IL-1 beta was not inhibited by anti-IL-8 IgG whereas anti-TNF alpha mAb reduced the infiltration by 68-75%. CONCLUSIONS: The involvement of IL-8 in TNF alpha- and IL-1 beta-induced neutrophil infiltration is limited. Factor(s) other than IL-8 appear to function as major neutrophil chemo-attractants.

Animals↗

Facial infiltrative lipomatosis.

BACKGROUND: Although there are multiple case reports and small series concerning facial infiltrative lipomatosis, there is no composite radiological description of the condition. OBJECTIVE: Radiological evaluation of facial infiltrative lipomatosis using plain film, sonography, CT and MRI. MATERIALS AND METHODS: We radiologically evaluated four patients with facial infiltrative lipomatosis. Initial plain radiographs of the face were acquired in all patients. Three children had an initial sonographic examination to evaluate the condition, followed by MRI. One child had a CT and then MRI. RESULTS: One child had abnormalities on plain radiographs. Sonographically, the lesions were seen as ill-defined heterogeneously hypoechoic areas with indistinct margins. On CT images, the lesions did not have a homogeneous fat density but showed some relatively more dense areas in deeper parts of the lesions. MRI provided better delineation of the exact extent of the process and characterization of facial infiltrative lipomatosis. CONCLUSION: Facial infiltrative lipomatosis should be considered as a differential diagnosis of vascular or lymphatic malformation when a child presents with unilateral facial swelling. MRI is the most useful single imaging modality to evaluate the condition, as it provides the best delineation of the exact extent of the process.

Adipose Tissue↗

MRI gadolinium enhancement of bone marrow: age-related changes in normals and in diffuse neoplastic infiltration.

OBJECTIVE: To quantify gadolinium-related enhancement in the bone marrow of the spine in normals and in patients with homogeneous diffuse malignant bone marrow infiltration. DESIGN AND PATIENTS: The patients consisted of two groups: group 1 comprised 94 healthy adults (18-86 years) without bone marrow disease and group 2 comprised 30 patients with homogeneous diffuse malignant bone marrow infiltration due to myeloma (n = 20) or breast carcinoma (n = 10). All patients received intravenous gadopentetate dimeglumine (Gd-DTPA), 0.1 mmol/kg body weight. Pre- and postcontrast signal intensity (SI) on T1-weighted spin-echo (SE) images (TR/TE: 572 ms/15 ms) was measured over a region of interest (ROI) and the percentage SI increase was calculated. The results were confirmed by bone marrow biopsy (n = 20) and clinical parameters (n = 10). Dynamic contrast-enhanced studies using a spoiled gradient-recalled-echo (GRE) sequence (TR/TE/alpha: 68 ms/6 ms 75 degrees) were performed in 10 controls with normal bone marrow. RESULTS AND CONCLUSION: Contrast material enhancement in healthy persons can vary greatly (range 3-59%, mean 21%, SD 11%). With increasing age there is a significant decrease in contrast enhancement (Pearson's correlation, P < 0.01). The percentage SI increase in patients with intermediate-grade (biopsy 20-50 vol%) and high-grade (biopsy > 50 vol%) diffuse malignant bone marrow infiltration was significantly higher than in normals (mean 67%, SD 34%, P < 0.001). Low-grade (biopsy < 20 vol%) diffuse malignant bone marrow infiltration can not be assessed by non-enhanced T1-weighted SE images or Gd-DTPA application. In conclusion, contrast material enhancement in healthy persons can vary greatly and is dependent on age, while intermediate-grade and high-grade diffuse malignant bone marrow infiltration can be objectively assessed with SI measurements.

Adolescent↗

Fluid resuscitation in liposuction: a prospective analysis of infiltrate-to-total aspirate ratios lower than used for the superwet technique.

BACKGROUND: Fluid management during liposuction appears to as much an art as it is a science. Because of different infiltration practices such as wet, superwet, and tumescent techniques, different fluid management guidelines are required. This has assumed greater significance as surgeons have undertaken aspirations with larger volumes (>/=4 l) and the potential complications of hypovolemia and fluid overload have materialized. METHODS: In this prospective study, 580 consecutive patients underwent liposuction using an average infiltrate-to-total aspirate ratio of 0.38. For all the patients, noninvasive hemodynamic parameters were assessed to evaluate a clinically based guideline for fluid management in liposuction. RESULTS: The average infiltrate-to-total aspirate ratio was 0.38 +/- 0.18 (range, 0.24-0.8). Total urine output was 1.63 ml/kg per hour (range, 1.06-3.4 ml/kg/h). The average postoperative heart rate was 92.16 beats/min, and the average postoperative mean blood pressure readings were 70.41 mmHg. The intraoperative fluid ratio, defined as the ratio of intraoperative intravenous fluid plus subcutaneous infiltrate to total aspirate, ranged from 0.98 to 2.1 (average, 1.25). The average percentage of body weight aspirated was 5.2% (range, 1.76-7.02%) CONCLUSION: This article presents a safe fluid management guideline based on experimental data from 580 patients who underwent liposuction using average infiltration-to-aspirate rates of 0.38. However, the calculated volumes from all the formulas should be viewed as educated guesses of the appropriate fluid load, and clinical judgment is essential.

Adolescent↗

Relationship between bone marrow angiogenesis and plasma cell infiltration and serum beta2-microglobulin levels in patients with multiple myeloma.

There is growing evidence that angiogenesis is important not only in solid tumors but also in hematological malignancies. Recently, we found that bone marrow angiogenesis is a prognostic factor for disease-related survival in patients with multiple myeloma. In this report, we addressed the question of whether the microvessel density in bone marrow biopsies is correlated to other myeloma parameters, e.g., serum beta2-microglobulin (beta2-MG) and plasma cell infiltration in the bone marrow. In 22 multiple myeloma patients, immunohistochemical, CD34-stained, paraffin-embedded bone marrow biopsies before and after chemotherapy were studied. Microvessels were counted in 400x magnification, and the mean number of vessels per area in each sample was noted as the microvessel density (MVD). Pretreatment bone marrow MVD (median: 44, range: 11-175 vessels/mm2) correlated significantly with the bone marrow plasma cell infiltration (median: 30%, range: 5-90%, r = 0.642, P=0.001) and beta2-MG (median: 2.74, range: 1.4-26.1 mg/l, r = 0.749, P < 0.0005). In contrast, there was no correlation between posttreatment MVD and plasma cell infiltration or beta2-MG (median: MVD 31, range: 0-221 vessels/mm2, median plasma cell infiltration: 15%, range: 5-80%, r = 0.229, P = 0.306 and median beta2-MG: 2.65, range: 1-27.6 mg/l, r = -0.042, P = 0.853). These findings show that the strong correlations between bone marrow MVD and plasma cell infiltration as well as serum beta2-MG levels disappear after chemotherapy. The underlying mechanisms need further investigations.

Biopsy↗