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Central nervous system involvement by multiple myeloma: A multi-institutional retrospective study of 172 patients in daily clinical practice

A. Jurczyszyn, N. Grzasko, A. Gozzetti, J. Czepiel, A. Cerase, V. Hungria, E. Crusoe, AL. Silva Dias, R. Vij, MA. Fiala, J. Caers, L. Rasche, AK. Nooka, S. Lonial, DH. Vesole, S. Philip, S. Gangatharan, A. Druzd-Sitek, J. Walewski, A. Corso, F....

. 2016 ; 91 (6) : 575-80. [pub] 20160424

Jazyk angličtina Země Spojené státy americké

Typ dokumentu časopisecké články, multicentrická studie

Perzistentní odkaz   https://www.medvik.cz/link/bmc17024130

The multicenter retrospective study conducted in 38 centers from 20 countries including 172 adult patients with CNS MM aimed to describe the clinical and pathological characteristics and outcomes of patients with multiple myeloma (MM) involving the central nervous system (CNS). Univariate and multivariate analyses were performed to identify prognostic factors for survival. The median time from MM diagnosis to CNS MM diagnosis was 3 years. Thirty-eight patients (22%) were diagnosed with CNS involvement at the time of initial MM diagnosis and 134 (78%) at relapse/progression. Upon diagnosis of CNS MM, 97% patients received initial therapy for CNS disease, of which 76% received systemic therapy, 36% radiotherapy and 32% intrathecal therapy. After a median follow-up of 3.5 years, the median overall survival (OS) from the onset of CNS involvement for the entire group was 7 months. Untreated and treated patients had median OS of 2 and 8 months, respectively (P < 0.001). At least one previous line of therapy for MM before the diagnosis of CNS disease and >1 cytogenetic abnormality detected by FISH were independently associated with worse OS. The median OS for patients with 0, 1 and 2 of these risk factors were 25 months, 5.5 months and 2 months, respectively (P < 0.001). Neurological manifestations, not considered chemotherapy-related, observed at any time after initial diagnosis of MM should raise a suspicion of CNS involvement. Although prognosis is generally poor, the survival of previously untreated patients and patients with favorable cytogenetic profile might be prolonged due to systemic treatment and/or radiotherapy. Am. J. Hematol. 91:575-580, 2016. © 2016 Wiley Periodicals, Inc.

Ankara University Medical School Ankara Turkey

Azienda Ospedaliera Universitaria Senese Siena Italy

Centre Hospitalier Universitaire de Liege Liege Belgium

Cliniques Universitaires Saint Luc Brussels Belgium

Columbia University Medical Center New York New York

Dana Farber Cancer Institute Harvard Medical School Boston Massachusetts

Department of Hematooncology and Bone Marrow Transplantation Medical University of Lublin Lublin Poland Department of Hematology St John's Cancer Center Lublin Poland

Fondazione IRCCS Policlinico San Matteo University of Pavia Pavia Italy

Fremantle Hospital Fremantle Australia

Gunma University Graduate School of Health Sciences Gunma Japan

Hopital La Miletrie CHU Poitiers France

Hospital Italiano de Buenos Aires Buenos Aires Argentina

Hospital Universitario de Salamanca Salamanca Spain

Jagiellonian University Medical College Cracow Poland

John Theurer Cancer Center at Hackensack UMC New Jersey and Georgetown University Washington DC

Karolinska University Hospital Stockholm Sweden

Levine Cancer Institute Carolinas HealthCare System Charlotte NC

Maria Sklodowska Curie Institute Oncology Center Warsaw Poland

Medical University Warsaw Poland

Memorial Sloan Kettering Cancer Center New York New York

National and Kapodistrian University of Athens Athens Greece

Norwegian University of Science and Technology Trondheim Norway

Odense University Hospital Odense Denmark

Pomeranian Medical University Szczecin Poland

Provincial Hospital Zielona Gora Poland

Queen Mary Hospital University of Hong Kong Hong Kong

Royal Victoria Hospital McGill University Montreal Canada

Santa Casa Medical School Sao Paulo Brazil

Silesian Medical University Katowice Poland

University Hospital Olomouc Olomouc Czech Republic

University Hospital Wuerzburg Wuerzburg Germany

University of Maryland Medical Center Baltimore Maryland

Vejle Hospital Vejle Denmark

VU University Medical Center Amsterdam the Netherlands

Washington University School of Medicine St Louis Missouri

Weill Cornell Medical College New York New York

Winship Cancer Institute Emory University Atlanta Georgia

Wroclaw Medical University Wroclaw Poland

Citace poskytuje Crossref.org

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