The current study assesses the characteristics and outcomes of multiple myeloma (MM) patients, treated with novel agents for hematogenous extramedullary (HEMM) relapse. Consecutive patients diagnosed with HEMM between 2010-2018 were included. Patients' characteristics at diagnosis and at HEMM presentation, response to treatment, survival and factors predicting survival were recorded and analyzed. A group of 127 patients, all diagnosed with HEMM by imaging (87.3%) and/or biopsy (79%), were included. Of those, 44% were initially diagnosed with ISS3, 57% presented with plasmacytomas, and 30% had high-risk cytogenetics. Median time to HEMM was 32 months. In multivariate analysis, ISS3 and bone plasmacytoma predicted shorter time to HEMM (P = .005 and P = .008, respectively). Upfront autograft was associated with longer time to HEMM (P = .002). At HEMM, 32% of patients had no BM plasmacytosis, 20% had non-secretory disease and 43% had light-chain disease. Multiple HEMM sites were reported in 52% of patients, mostly involving soft tissue, skin (29%), and pleura/lung (25%). First treatment for HEMM included proteasome inhibitors (50%), immunomodulatory drugs (IMiDs) (39%), monoclonal antibodies (10%), and chemotherapy (53%). Overall response rate (ORR) was 57%. IMiDs were associated with higher ORR (HR 2.2, 95% CI 1.02-4.7, P = .04). Median survival from HEMM was 6 months (CI 95% 4.8-7.2). Failure to achieve ≥VGPR was the only significant factor for worse OS in multivariate analyses (HR = 9.87, CI 95% 2.35 - 39, P = .001). In conclusion, HEMM occurs within 3 years of initial myeloma diagnosis and is associated with dismal outcome. The IMiDs might provide a higher response rate, and achievement of ≥VGPR predicts longer survival.

• MeSH
• autologní štěp MeSH
• centrální nervový systém patologie   MeSH
• doba přežití bez progrese choroby MeSH
• dospělí MeSH
• imunologické faktory aplikace a dávkování   MeSH
• inhibitory proteasomu aplikace a dávkování   MeSH
• játra patologie   MeSH
• Kaplanův-Meierův odhad MeSH
• kombinovaná terapie MeSH
• kůže patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lymfatické uzliny patologie   MeSH
• mnohočetný myelom krev   farmakoterapie   patologie   terapie   MeSH
• nádorové cirkulující buňky * MeSH
• nádorové kmenové buňky patologie   MeSH
• nádory kostí krev   farmakoterapie   patologie   terapie   MeSH
• orgánová specificita MeSH
• plazmatické buňky patologie   MeSH
• plazmocytom krev   farmakoterapie   patologie   terapie   MeSH
• pleura patologie   MeSH
• plíce patologie   MeSH
• proporcionální rizikové modely MeSH
• protinádorové látky imunologicky aktivní aplikace a dávkování   MeSH
• protokoly antitumorózní kombinované chemoterapie terapeutické užití   MeSH
• recidiva MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• transplantace hematopoetických kmenových buněk MeSH
• záchranná terapie metody   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH