BACKGROUND: Intracranial involvement in multiple myeloma is extremely rare. The effect of new drugs (eg, thalidomide, bortezomib, lenalidomide) with respect to old drugs (eg, alkylators, steroids) has not been reported. METHODS: We collected clinical and biological data of patients presenting with an osteo-dural or primary dural multiple myeloma (OD-DMM) or a central nervous system myelomatosis (CNS-MM) by sending a questionnaire to the centers of the Gruppo Italiano Malattie Ematologiche dell'Adulto (GIMEMA). RESULTS: A total of 50 patients were registered. New therapies were used in 35 patients, whereas 15 patients received old treatments. Twenty-five out of 50 patients obtained a complete remission or a very good partial remission (CR+VGPR). Overall survival (OS) for CNS-MM was 6 months, for OD-DMM 25 months. OS was 25 months for patients treated with new agents versus 8 months with old agents. Improved OS and progression-free survival were predicted by response (CR+VGPR) and by patients who underwent stem cell transplantation versus chemotherapy. β2-Microglobulin >5 mmol/L was a poor prognostic factor. Multivariate analysis showed poor survival for patients with β2-microglobulin >5 mmol/L and better survival for patients achieving CR+VGPR. CONCLUSIONS: The overall data highlight the relevance of therapy with new drugs in intracranial myeloma, providing a framework for future clinical trials.
BACKGROUND: Intracranial involvement in multiple myeloma is extremely rare. The effect of new drugs (eg, thalidomide, bortezomib, lenalidomide) with respect to old drugs (eg, alkylators, steroids) has not been reported. METHODS: We collected clinical and biological data of patients presenting with an osteo-dural or primary dural multiple myeloma (OD-DMM) or a central nervous system myelomatosis (CNS-MM) by sending a questionnaire to the centers of the Gruppo Italiano Malattie Ematologiche dell'Adulto (GIMEMA). RESULTS: A total of 50 patients were registered. New therapies were used in 35 patients, whereas 15 patients received old treatments. Twenty-five out of 50 patients obtained a complete remission or a very good partial remission (CR+VGPR). Overall survival (OS) for CNS-MM was 6 months, for OD-DMM 25 months. OS was 25 months for patients treated with new agents versus 8 months with old agents. Improved OS and progression-free survival were predicted by response (CR+VGPR) and by patients who underwent stem cell transplantation versus chemotherapy. β2-Microglobulin >5 mmol/L was a poor prognostic factor. Multivariate analysis showed poor survival for patients with β2-microglobulin >5 mmol/L and better survival for patients achieving CR+VGPR. CONCLUSIONS: The overall data highlight the relevance of therapy with new drugs in intracranial myeloma, providing a framework for future clinical trials.
Authors: Artur Jurczyszyn; Norbert Grzasko; Alessandro Gozzetti; Jacek Czepiel; Alfonso Cerase; Vania Hungria; Edvan Crusoe; Ana Luiza Miranda Silva Dias; Ravi Vij; Mark A Fiala; Jo Caers; Leo Rasche; Ajay K Nooka; Sagar Lonial; David H Vesole; Sandhya Philip; Shane Gangatharan; Agnieszka Druzd-Sitek; Jan Walewski; Alessandro Corso; Federica Cocito; Marie-Christine M Vekemans; Erden Atilla; Meral Beksac; Xavier Leleu; Julio Davila; Ashraf Badros; Ekta Aneja; Niels Abildgaard; Efstathios Kastritis; Dorotea Fantl; Natalia Schutz; Tomas Pika; Aleksandra Butrym; Magdalena Olszewska-Szopa; Lidia Usnarska-Zubkiewicz; Saad Z Usmani; Hareth Nahi; Chor S Chim; Chaim Shustik; Krzysztof Madry; Suzanne Lentzsch; Alina Swiderska; Grzegorz Helbig; Renata Guzicka-Kazimierczak; Nikoletta Lendvai; Anders Waage; Kristian T Andersen; Hirokazu Murakami; Sonja Zweegman; Jorge J Castillo Journal: Am J Hematol Date: 2016-04-24 Impact factor: 10.047
Authors: Veeravich Jaruvongvanich; Ittikorn Spanuchart; Pichaya O-Charoen; Christian Kitamura; Lauren Sumida; Marina Roytman Journal: Hawaii J Med Public Health Date: 2016-04