Guang Li1,2, Yan-Ping Song1, Yao Lv2, Zhen-Zhen Li1, Yan-Hua Zheng2. 1. Institute of Hematology, Xi'an Central Hospital, Xi'an, Shaanxi, China. 2. Department of Hematology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
Abstract
BACKGROUND: Extramedullary disease (EMD), an infrequent manifestation of multiple myeloma (MM), can present at diagnosis or develop during the disease course. EMD can be clinically divided into bone-related EMD (EMD-B) and soft tissue-related EMD (EMD-S). The purpose of our study is to investigate the clinical characteristics, survival outcomes, and prognostic factors of MM patients with EMD. METHODS: A total of 155 MM patients with EMD were ultimately enrolled in our study by retrieving the Surveillance, Epidemiology, and End Results (SEER) database. The Kaplan-Meier survival curves and log-rank test for overall survival (OS) and myeloma-specific survival (MSS) were conducted to compare each potential variable. Variables with a p value <0.1 in the univariate Cox regression were incorporated into the multivariate Cox model to determine the independent prognostic factors, with a hazard ratio (HR) >1 representing adverse prognostic factors. RESULTS: The median age at diagnosis was 63 years old. EMD-B occurred in 99 patients (63.90%), while EMD-S occurred in 56 cases (36.10%). Patients with EMD-S had a significant survival disadvantage in MSS (HR = 1.844, 95% CI 1.117-3.042, p = 0.017) and OS (HR = 1.853, 95% CI 1.166-2.942, p = 0.009) compared to those with EMD-B. Patients with EMD interval ≤24 months were at higher risk of death than those with EMD at diagnosis in MSS (HR = 1.885, 95% CI 1.175-3.346, p = 0.042) and in OS (HR = 1.33, 95% CI 1.119-2.529, p = 0.036). Patients with EMD interval >24 months were at a lower risk of death as opposed to those with EMD at diagnosis. CONCLUSION: Age at MM diagnosis, site of EMD, and time interval from diagnosis to EMD occurrence were independent prognostic factors in MM patients with EMD. EMD-B bore a better prognosis than EMD-S.
BACKGROUND: Extramedullary disease (EMD), an infrequent manifestation of multiple myeloma (MM), can present at diagnosis or develop during the disease course. EMD can be clinically divided into bone-related EMD (EMD-B) and soft tissue-related EMD (EMD-S). The purpose of our study is to investigate the clinical characteristics, survival outcomes, and prognostic factors of MM patients with EMD. METHODS: A total of 155 MM patients with EMD were ultimately enrolled in our study by retrieving the Surveillance, Epidemiology, and End Results (SEER) database. The Kaplan-Meier survival curves and log-rank test for overall survival (OS) and myeloma-specific survival (MSS) were conducted to compare each potential variable. Variables with a p value <0.1 in the univariate Cox regression were incorporated into the multivariate Cox model to determine the independent prognostic factors, with a hazard ratio (HR) >1 representing adverse prognostic factors. RESULTS: The median age at diagnosis was 63 years old. EMD-B occurred in 99 patients (63.90%), while EMD-S occurred in 56 cases (36.10%). Patients with EMD-S had a significant survival disadvantage in MSS (HR = 1.844, 95% CI 1.117-3.042, p = 0.017) and OS (HR = 1.853, 95% CI 1.166-2.942, p = 0.009) compared to those with EMD-B. Patients with EMD interval ≤24 months were at higher risk of death than those with EMD at diagnosis in MSS (HR = 1.885, 95% CI 1.175-3.346, p = 0.042) and in OS (HR = 1.33, 95% CI 1.119-2.529, p = 0.036). Patients with EMD interval >24 months were at a lower risk of death as opposed to those with EMD at diagnosis. CONCLUSION: Age at MM diagnosis, site of EMD, and time interval from diagnosis to EMD occurrence were independent prognostic factors in MM patients with EMD. EMD-B bore a better prognosis than EMD-S.
Authors: W J Chng; T Price-Troska; N Gonzalez-Paz; S Van Wier; S Jacobus; E Blood; K Henderson; M Oken; B Van Ness; P Greipp; S V Rajkumar; R Fonseca Journal: Leukemia Date: 2007-01-11 Impact factor: 11.528
Authors: Laura Rosiñol; Ma Teresa Cibeira; Joan Bladé; Jordi Esteve; Marta Aymerich; María Rozman; Marta Segarra; Maria C Cid; Xavier Filella; Emili Montserrat Journal: Haematologica Date: 2004-07 Impact factor: 9.941
Authors: Matteo Claudio Da Vià; Antonio Giovanni Solimando; Andoni Garitano-Trojaola; Santiago Barrio; Umair Munawar; Susanne Strifler; Larissa Haertle; Nadine Rhodes; Eva Teufel; Cornelia Vogt; Constantin Lapa; Andreas Beilhack; Leo Rasche; Hermann Einsele; K Martin Kortüm Journal: Oncologist Date: 2019-10-18