Supplementary Material for: Microvessel Density as a Surrogate Prognostic Marker in Patients with Multiple Myeloma: A Meta-Analysis

<p><b><i>Background/Aims:</i></b> Bone marrow (BM) angiogenesis is considered a hallmark of multiple myeloma (MM) development and progression, and can be quantified with the use of microvessel density (MVD). The purpose of this study is to provide a review and a meta-analysis of the current literature regarding the prognostic value of MVD in the overall survival (OS) of MM patients. <b><i>Methods:</i></b> MEDLINE was screened for studies evaluating the OS of MM patients with regard to their MVD count in BM trephine. The pooled hazard ratio (HR) and its associated 95% confidence interval (CI) among MM patients with a high and low MVD count was the primary end point. Secondary outcomes included odds ratios (OR) for 12-, 36-, and 60-month survival. <b><i>Results:</i></b> Ten eligible trials were identified for the analysis of the primary end point and 9 for the secondary end points. Pooled HR for OS was 1.85 (95% CI: 1.25-2.73, <i>p</i> = 0.002). The pooled OR of survival were 1.59 (95% CI: 1.02-2.46, <i>p</i> = 0.04) at 12 months, 2.90 (95% CI: 1.68-5.03, <i>p</i> = 0.0001) at 36 months, and 3.42 (95% CI: 2.41-4.85, <i>p</i> < 0.00001) at 60 months, in favor of the low MVD group. <b><i>Conclusion:</i></b> This meta-analysis provides persuasive evidence that MVD has significant impact on the clinical outcome of MM patients.</p>