Περίληψη:
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.
Συγγραφείς:
Jurczyszyn, A.
Grzasko, N.
Gozzetti, A.
Czepiel, J.
Cerase, A.
Hungria, V.
Crusoe, E.
Silva Dias, A.L.M.
Vij, R.
Fiala, M.A.
Caers, J.
Rasche, L.
Nooka, A.K.
Lonial, S.
Vesole, D.H.
Philip, S.
Gangatharan, S.
Druzd-Sitek, A.
Walewski, J.
Corso, A.
Cocito, F.
Vekemans, M.-C.M.
Atilla, E.
Beksac, M.
Leleu, X.
Davila, J.
Badros, A.
Aneja, E.
Abildgaard, N.
Kastritis, E.
Fantl, D.
Schutz, N.
Pika, T.
Butrym, A.
Olszewska-Szopa, M.
Usnarska-Zubkiewicz, L.
Usmani, S.Z.
Nahi, H.
Chim, C.S.
Shustik, C.
Madry, K.
Lentzsch, S.
Swiderska, A.
Helbig, G.
Guzicka-Kazimierczak, R.
Lendvai, N.
Waage, A.
Andersen, K.T.
Murakami, H.
Zweegman, S.
Castillo, J.J.
Λέξεις-κλειδιά:
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
