Identification of patients at high risk of secondary extramedullary multiple myeloma development
| Autor: | Tomas Jelinek, Jiri Minarik, Ivan Spicka, Petra Krhovska, Viera Sandecká, Martin Stork, Ludek Pour, Jan Straub, Sabina Ševčíková, Petr Pavlicek, Alexandra Jungova, Jakub Radocha, Roman Hájek, Lucie Brozova, Jiri Jarkovsky, Vladimir Maisnar, Lenka Pospisilova |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Immunoglobulin A medicine.medical_specialty Younger age Aggressive disease Newly diagnosed Gastroenterology 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Humans Medicine Multiple myeloma Aged Retrospective Studies biology business.industry Hematology Prognosis medicine.disease Survival Analysis 3. Good health medicine.anatomical_structure Extramedullary disease Plasma cell infiltration 030220 oncology & carcinogenesis biology.protein Female Bone marrow Multiple Myeloma business 030215 immunology |
| Zdroj: | British Journal of Haematology. 196:954-962 |
| ISSN: | 1365-2141 0007-1048 |
| DOI: | 10.1111/bjh.17925 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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