@article{3101098,
    title = "Central nervous system involvement by multiple myeloma: A multi-institutional retrospective study of 172 patients in daily clinical practice",
    author = "Jurczyszyn, A. and Grzasko, N. and Gozzetti, A. and Czepiel, J. and Cerase, A. and Hungria, V. and Crusoe, E. and Silva Dias, A.L.M. and Vij, R. and Fiala, M.A. and Caers, J. and Rasche, L. and Nooka, A.K. and Lonial, S. and Vesole, D.H. and Philip, S. and Gangatharan, S. and Druzd-Sitek, A. and Walewski, J. and Corso, A. and Cocito, F. and Vekemans, M.-C.M. and Atilla, E. and Beksac, M. and Leleu, X. and Davila, J. and Badros, A. and Aneja, E. and Abildgaard, N. and Kastritis, E. and Fantl, D. and Schutz, N. and Pika, T. and Butrym, A. and Olszewska-Szopa, M. and Usnarska-Zubkiewicz, L. and Usmani, S.Z. and Nahi, H. and Chim, C.S. and Shustik, C. and Madry, K. and Lentzsch, S. and Swiderska, A. and Helbig, G. and Guzicka-Kazimierczak, R. and Lendvai, N. and Waage, A. and Andersen, K.T. and Murakami, H. and Zweegman, S. and Castillo, J.J.",
    journal = "American Journal of Hematology",
    year = "2016",
    volume = "91",
    number = "6",
    pages = "575-580",
    publisher = "Wiley-Liss, Inc.",
    issn = "0361-8609, 1096-8652",
    doi = "10.1002/ajh.24351",
    keywords = "proteasome inhibitor;  steroid;  antineoplastic agent, adult;  aged;  Article;  cancer growth;  cancer patient;  cancer prognosis;  cancer radiotherapy;  cancer recurrence;  cancer survival;  central nervous system multiple myeloma;  central nervous system tumor;  clinical practice;  cytogenetics;  fluorescence in situ hybridization;  human;  major clinical study;  multicenter study (topic);  multiple myeloma;  overall survival;  priority journal;  retrospective study;  risk factor;  systemic therapy;  Central Nervous System Neoplasms;  chromosome aberration;  clinical trial;  complication;  female;  male;  middle aged;  mortality;  multicenter study;  multimodality cancer therapy;  multiple myeloma;  pathology;  prognosis;  radiotherapy;  secondary;  survival analysis;  survival rate;  treatment outcome;  very elderly, Adult;  Aged;  Aged, 80 and over;  Antineoplastic Agents;  Central Nervous System Neoplasms;  Chromosome Aberrations;  Combined Modality Therapy;  Female;  Humans;  Male;  Middle Aged;  Multiple Myeloma;  Prognosis;  Radiotherapy;  Retrospective Studies;  Survival Analysis;  Survival Rate;  Treatment Outcome",
    abstract = "The multicenter retrospective study conducted in 38 centers from 20 countries including 172 adult patients with CNS MM aimed to describe the clinical and pathological characteristics and outcomes of patients with multiple myeloma (MM) involving the central nervous system (CNS). Univariate and multivariate analyses were performed to identify prognostic factors for survival. The median time from MM diagnosis to CNS MM diagnosis was 3 years. Thirty-eight patients (22%) were diagnosed with CNS involvement at the time of initial MM diagnosis and 134 (78%) at relapse/progression. Upon diagnosis of CNS MM, 97% patients received initial therapy for CNS disease, of which 76% received systemic therapy, 36% radiotherapy and 32% intrathecal therapy. After a median follow-up of 3.5 years, the median overall survival (OS) from the onset of CNS involvement for the entire group was 7 months. Untreated and treated patients had median OS of 2 and 8 months, respectively (P<0.001). At least one previous line of therapy for MM before the diagnosis of CNS disease and >1 cytogenetic abnormality detected by FISH were independently associated with worse OS. The median OS for patients with 0, 1 and 2 of these risk factors were 25 months, 5.5 months and 2 months, respectively (P<0.001). Neurological manifestations, not considered chemotherapy-related, observed at any time after initial diagnosis of MM should raise a suspicion of CNS involvement. Although prognosis is generally poor, the survival of previously untreated patients and patients with favorable cytogenetic profile might be prolonged due to systemic treatment and/or radiotherapy. © 2016 Wiley Periodicals, Inc."
}