Flora Zagouri1, Efstathios Kastritis1, Athanasios Zomas2, Evangelos Terpos1, Eirini Katodritou3, Argiris Symeonidis4, Sosana Delimpasi5, Anastasia Pouli6, Theodoros P Vassilakopoulos7, Eurydiki Michalis8, Stavroula Giannouli9, Zafiris Kartasis10, Anna Christoforidou11, Kiriaki Kokoviadou12, Eleftheria Hatzimichael13, Dimitra Gika1, Catherine Megalakaki14, Maria Papaioannou15, Marie-Christine Kyrtsonis16, Kostas Konstantopoulos7, Meletios A Dimopoulos1. 1. Department of Clinical Therapeutics, Medical School, National and Kapodistrian University of Athens, Athens, Greece. 2. Department of Internal Medicine, Attikon Hospital, Haidari, Greece. 3. Department of Hematology, "Theageneion" Hospital, Thessaloniki, Greece. 4. Hematology Division, Department of Internal Medicine, University of Patras Medical School, Patras, Greece. 5. Bone Marrow Transplantation and Lymphoma Unit, "Evangelismos" Hospital, Athens, Greece. 6. Department of Hematology, "Aghios Savvas" Hospital, Athens, Greece. 7. Department of Hematology and BMT Unit, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece. 8. Department of Hematology, "G. Gennimatas" Hospital, Athens, Greece. 9. 2nd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece. 10. Chalkis General Hospital, Chalkis, Greece. 11. Department of Hematology, Democritus University of Thrace Faculty of Medicine, Alexandroupolis, Greece. 12. Department of Hematology, "Papageorgiou" Hospital, Thessaloniki, Greece. 13. Department of Hematology, University of Ioannina, Ioannina, Greece. 14. Department of Hematology, "Metaxa" Hospital, Piraeus, Greece. 15. AHEPA University General Hospital of Thessaloniki, Thessaloniki, Greece. 16. First Department of Propaedeutic and Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Abstract
OBJECTIVES: To evaluate the prognostic impact of hypercalcemia in newly diagnosed patients with symptomatic multiple myeloma (MM), especially after the incorporation of new agents. METHODS: we analyzed the outcomes of newly diagnosed patients with symptomatic myeloma included in the database of the Greek Myeloma Study Group for the prognostic effect of the presence of hypercalcemia (defined as corrected serum calcium ≥11 mg/dL) at diagnosis. RESULTS: Among 2129 consecutive patients with symptomatic MM, 19.5% presented with hypercalcemia at the time of diagnosis. The presence of hypercalcemia was associated with anemia, thrombocytopenia, lower estimated glomerular filtration rate (eGFR), advanced ISS stage, and presence of lytic lesions. Hypercalcemia was more common in patients with high-risk cytogenetics and was associated with inferior survival across different time periods, age groups, and primary treatments. Hypercalcemia was also associated with a twofold increase in the risk of early death. In patients without available FISH, hypercalcemia could substitute for the presence of high-risk cytogenetics and identify patients with worse prognosis along with ISS stage and elevated serum LDH. CONCLUSION: Hypercalcemia remains a poor prognostic feature in the era of novel agents despite the improvement in the outcomes of patients who present with elevated calcium.
OBJECTIVES: To evaluate the prognostic impact of hypercalcemia in newly diagnosed patients with symptomatic multiple myeloma (MM), especially after the incorporation of new agents. METHODS: we analyzed the outcomes of newly diagnosed patients with symptomatic myeloma included in the database of the Greek Myeloma Study Group for the prognostic effect of the presence of hypercalcemia (defined as corrected serum calcium ≥11 mg/dL) at diagnosis. RESULTS: Among 2129 consecutive patients with symptomatic MM, 19.5% presented with hypercalcemia at the time of diagnosis. The presence of hypercalcemia was associated with anemia, thrombocytopenia, lower estimated glomerular filtration rate (eGFR), advanced ISS stage, and presence of lytic lesions. Hypercalcemia was more common in patients with high-risk cytogenetics and was associated with inferior survival across different time periods, age groups, and primary treatments. Hypercalcemia was also associated with a twofold increase in the risk of early death. In patients without available FISH, hypercalcemia could substitute for the presence of high-risk cytogenetics and identify patients with worse prognosis along with ISS stage and elevated serum LDH. CONCLUSION:Hypercalcemia remains a poor prognostic feature in the era of novel agents despite the improvement in the outcomes of patients who present with elevated calcium.
Authors: Ala Abudayyeh; Heather Lin; Omar Mamlouk; Maen Abdelrahim; Rima Saliba; Gabriela Rondon; Charles S Martinez; Ruby Delgado; Valda Page; Arun Rajasekaran; Paul W Sanders; Muzaffar Qazilbash Journal: Leuk Lymphoma Date: 2020-07-29
Authors: Fadi Nasr; Ahmad Al Ghoche; Saada Diab; Lewis Nasr; Emmanuel Ammanouil; Christelle Riachy; Souheil Hallit; Georges Chahine Journal: Leuk Res Rep Date: 2021-05-24