Identification of patients at high risk of secondary extramedullary multiple myeloma development.


Journal

British journal of haematology
ISSN: 1365-2141
Titre abrégé: Br J Haematol
Pays: England
ID NLM: 0372544

Informations de publication

Date de publication:
02 2022
Historique:
received: 17 08 2021
accepted: 14 10 2021
pubmed: 3 11 2021
medline: 3 3 2022
entrez: 2 11 2021
Statut: ppublish

Résumé

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.

Identifiants

pubmed: 34726261
doi: 10.1111/bjh.17925
pmc: PMC9297924
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

954-962

Informations de copyright

© 2021 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.

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Auteurs

Martin Stork (M)

Department of Internal Medicine, Hematology and Oncology, University Hospital Brno, Brno, Czech Republic.

Sabina Sevcikova (S)

Babak Myeloma Group, Department of Pathophysiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic.

Jiri Minarik (J)

Department of Hemato-Oncology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic.

Petra Krhovska (P)

Department of Hemato-Oncology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic.

Jakub Radocha (J)

4th Department of Internal Medicine - Hematology, Faculty Hospital and Charles University in Hradec Kralove, Hradec Kralove, Czech Republic.

Lenka Pospisilova (L)

Institute of Biostatistics and Analyses, Ltd., Brno, Czech Republic.

Lucie Brozova (L)

Institute of Biostatistics and Analyses, Ltd., Brno, Czech Republic.

Jiri Jarkovsky (J)

Institute of Biostatistics and Analyses, Ltd., Brno, Czech Republic.

Ivan Spicka (I)

1st Medical Department - Clinical Department of Haematology of the First Faculty of Medicine and General Teaching Hospital Charles University, Prague, Czech Republic.

Jan Straub (J)

Department of Internal Medicine and Hematology, University Hospital Kralovske Vinohrady, Prague, Czech Republic.

Petr Pavlicek (P)

Department of Internal Medicine and Hematology, University Hospital Kralovske Vinohrady, Prague, Czech Republic.

Alexandra Jungova (A)

Hematology and Oncology Department, Charles University Hospital, Pilsen, Czech Republic.

Tomas Jelinek (T)

Department of Hematooncology, University Hospital Ostrava and Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.

Viera Sandecka (V)

Department of Internal Medicine, Hematology and Oncology, University Hospital Brno, Brno, Czech Republic.

Vladimir Maisnar (V)

4th Department of Internal Medicine - Hematology, Faculty Hospital and Charles University in Hradec Kralove, Hradec Kralove, Czech Republic.

Roman Hajek (R)

Department of Hematooncology, University Hospital Ostrava and Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.

Ludek Pour (L)

Department of Internal Medicine, Hematology and Oncology, University Hospital Brno, Brno, Czech Republic.

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