There are several independent prognostic factors for MM, like high levels of beta-2 microglobulin, hypodiploidy chromosome content, deletion of chromosome 13q14 and also the extent of angiogenesis, shown by microvascular density (MVD), in BM [Fonseca et al, 2004; Kumar et al, 2002; Pruneri et al, 2002; Sezer et al, 2000]. It has been suggested that MM progressed from an avascular to a vascular phase (active MM) accompanied by a significant increase in MVD in BM [Rajkumar et al, 2002], which is promoted by the angiogenesis related factors, like VEGF, bFGF, and PDGF, which were performed like a paracrine or autocrine loops secreted by MM cells per se or the adjacent BM stromal cells [Gupta et al, 2001; Kumar et al, 2003; Ria et al, 2003; Vacca et al, 2003]. It has been reported that higher MVD in BM at the time of initial diagnosis was associated with shorter OS and PFS in patients undergoing autologous transplantation for MM than the patients with lower MVD [Kumar et al, 2004]. Those angiogenesis related factors may provide disease monitoring but also a potent novel therapeutic approach to over come resistance to therapies and thereby improve patient outcome [Podar et al, 2004]. Interestingly, the patients with deletion of chromosome 13q14 have higher MVD in BM than the patients without [Schreiber 2000], which hinted that the grave prognosis of deletion of chromosome 13q14 might be a result of dysregulation of angiogenesis in BM. However, on the other hand, absence of clinical prognostic value of VEGF and MVD in MM had also been reported by other investigators [Ahn et al, 2001; Choi et al, 2002]. In MM, whether the MVD in BM and the related biological markers, like VEGF, bFGF, and PDGF can serve as prognostic factors are still debate [Rajkumar et al, 2001; Vacca et al, 2001]. There are possible two reasons for the debate, the first one is that the distribution of neoplastic foci within the BM of MM are not homogenous, therefore the microvascular densities calculated from a single site BM specimen are hard to represent the total angiogenesis within the BM; the second one is that the angiogenesis related biological markers, such as VEGF, bFGF, and PDGF, in MM are largely studied on the plasmas obtained from peripheral blood rather than BM, and this is a critical issue for the cytokines secreted from either MM cells or adjacent stromal cells are mostly paracrines or autocrines and the levels of VEGF, bFGF, PDGF are higher in BM than in peripheral blood [Di Raimondo et al, 2000].