Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Author:
Kanellias Nikolaos
Dissertation committee:
Μαρία Χριστίνα Κυρτσώνη, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Μελέτιος-Αθανάσιος Δημόπουλος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ευάγγελος Τέρπος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Καστρίτης Ευστάθιος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κουτουλίδης Βασίλειος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ζαγουρή Φλώρα, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Λιόντος Μιχάλης, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Μελέτη έκφρασης γενετικών πολυμορφισμών που συνδέονται με μεταβολές της οστικής πυκνότητας σε ασθενείς με Πολλαπλό Μυέλωμα
Translated title:
Expression of genetic polymorphism associated with changes in bone mineral density in patients with Multiple Myeloma. A single-center study.
Summary:
Multiple myeloma (MM) represents one of the most common hematological malignancy, accounting for 10 %of all hematologic malignancies and 1% of all cancers [1]. In 2018, 48,300 adults were estimated to be newly diagnosed with MM (NDMM), and 30 900 have died from the disease [2]. The median age at diagnosis is 65 years. Less than 3% of patients are diagnosed before the age of 40. One of MM hallmarks is osteolytic bone disease due to an elevated function of osteoclasts which is not accompanied by effective osteoblast function[3]. Osteolytic lesions are detected in 70–80% of patients at diagnosis and increase the risk for skeletal-related events (SREs: pathologic fractures, spinal cord compression (SCC), requirement for surgery or palliative radiotherapy to bone). SREs have a profound impact on the quality of life (QoL) and survival of MM patients and affect both clinical and economic aspects of their life
Contemporary information is sparse on the frequency of skeletal-related events (SREs) in multiple myeloma (MM) patients at a population-based level in the era of novel agents. In this context, we conducted this single-center, prospective, observational study to determine the incidence of SREs among newly diagnosed MMs (NDMM) and to explore the possible correlations with disease characteristics, imaging finding, and patient prognosis. A total of 370 patients with available baseline MRIs were included. Among them, 208 (56%) presented with at least one SRE at diagnosis. Fractures were the most common reported SREs (48%). The incidence of SREs at diagnosis was higher in patients with osteolytic lesions, abnormal MRI pattern, hypercalcemia, and at least 60% bone marrow infiltration by plasma cells. Importantly, the patients with normal MRI pattern, who did not present with SREs at diagnosis, had statistically significant improved median OS in comparison with the patients who had abnormal MRI patterns and/or the presence of SREs at diagnosis (9.3 vs. 6.6 years, p = 0.048). Our data, which represent one of a few systematic reports on the incidence and characteristics of SREs in the era of novel agents, was indicative of a high incidence of SREs at the time of MM diagnosis. Early detection of myeloma bone disease and tailored patient management are essential to optimize patient outcomes.
Main subject category:
Health Sciences
Keywords:
Multiple Myeloma, Bone disease, Skeletal related events, Bisphosponates, Osteoporosis
Number of references:
506
File:
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Kanellias_Nikolaos_PhD.pdf
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