Identification of patients at high risk of secondary extramedullary multiple myeloma development
© 2021 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd..
Multiple myeloma (MM) is characterized by malignant plasma cell infiltration of the bone marrow. In extramedullary multiple myeloma (EMD), a subclone of these cells migrates out of the bone marrow. Out of 4 985 MM patients diagnosed between 2005 and 2017 in the Czech Republic, we analyzed 234 secondary EMD patients to clarify risk factors of secondary EMD development. We found younger age [<65 years; odds ratio (OR) 4·38, 95% confidence interval (CI): 2·46-7·80, P < 0·0001], high lactate dehydrogenase (LDH) levels (>5 μkat/l; OR 2·07, 95% CI: 1·51-2·84, P < 0·0001), extensive osteolytic activity (OR 2·21, 95% CI: 1·54-3·15, P < 0·001), and immunoglobulin A (IgA; OR 1·53, 95% CI: 1·11-2·11, P = 0·009) or the non-secretory type of MM (OR 2·83; 95% CI: 1·32-6·04, P = 0·007) at the time of MM diagnosis to be the main risk factors for secondary EMD development. Newly diagnosed MM (NDMM) patients with subsequent EMD had inferior median progression-free (PFS) and overall (OS) survival when compared to NDMM patients without future EMD [mPFS: 13·8 months (95% CI: 11·4-16·3) vs 18·8 months (95% CI: 17·7-19·9), P = 0·006; mOS: 26·7 months (95% CI: 18·1-35·4) vs 58·7 months (95% CI: 54·8-62·6), P < 0·001]. We found that NDMM patients with specific risk factors associated with secondary EMD development have a more aggressive disease course before secondary EMD develops.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:196 |
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| Enthalten in: |
British journal of haematology - 196(2022), 4 vom: 05. Feb., Seite 954-962 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Stork, Martin [VerfasserIn] |
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| Links: |
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| Themen: |
Extramedullary disease |
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| Anmerkungen: |
Date Completed 01.03.2022 Date Revised 31.07.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/bjh.17925 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 520 | |a © 2021 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd. | ||
| 520 | |a Multiple myeloma (MM) is characterized by malignant plasma cell infiltration of the bone marrow. In extramedullary multiple myeloma (EMD), a subclone of these cells migrates out of the bone marrow. Out of 4 985 MM patients diagnosed between 2005 and 2017 in the Czech Republic, we analyzed 234 secondary EMD patients to clarify risk factors of secondary EMD development. We found younger age [<65 years; odds ratio (OR) 4·38, 95% confidence interval (CI): 2·46-7·80, P < 0·0001], high lactate dehydrogenase (LDH) levels (>5 μkat/l; OR 2·07, 95% CI: 1·51-2·84, P < 0·0001), extensive osteolytic activity (OR 2·21, 95% CI: 1·54-3·15, P < 0·001), and immunoglobulin A (IgA; OR 1·53, 95% CI: 1·11-2·11, P = 0·009) or the non-secretory type of MM (OR 2·83; 95% CI: 1·32-6·04, P = 0·007) at the time of MM diagnosis to be the main risk factors for secondary EMD development. Newly diagnosed MM (NDMM) patients with subsequent EMD had inferior median progression-free (PFS) and overall (OS) survival when compared to NDMM patients without future EMD [mPFS: 13·8 months (95% CI: 11·4-16·3) vs 18·8 months (95% CI: 17·7-19·9), P = 0·006; mOS: 26·7 months (95% CI: 18·1-35·4) vs 58·7 months (95% CI: 54·8-62·6), P < 0·001]. We found that NDMM patients with specific risk factors associated with secondary EMD development have a more aggressive disease course before secondary EMD develops | ||
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| 700 | 1 | |a Minarik, Jiri |e verfasserin |4 aut | |
| 700 | 1 | |a Krhovska, Petra |e verfasserin |4 aut | |
| 700 | 1 | |a Radocha, Jakub |e verfasserin |4 aut | |
| 700 | 1 | |a Pospisilova, Lenka |e verfasserin |4 aut | |
| 700 | 1 | |a Brozova, Lucie |e verfasserin |4 aut | |
| 700 | 1 | |a Jarkovsky, Jiri |e verfasserin |4 aut | |
| 700 | 1 | |a Spicka, Ivan |e verfasserin |4 aut | |
| 700 | 1 | |a Straub, Jan |e verfasserin |4 aut | |
| 700 | 1 | |a Pavlicek, Petr |e verfasserin |4 aut | |
| 700 | 1 | |a Jungova, Alexandra |e verfasserin |4 aut | |
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| 700 | 1 | |a Sandecka, Viera |e verfasserin |4 aut | |
| 700 | 1 | |a Maisnar, Vladimir |e verfasserin |4 aut | |
| 700 | 1 | |a Hajek, Roman |e verfasserin |4 aut | |
| 700 | 1 | |a Pour, Ludek |e verfasserin |4 aut | |
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