The impact of extramedullary disease at presentation on the outcome of myeloma. Leuk Lymphoma 2009 Feb;50(2):230-5
Date
02/07/2009Pubmed ID
19197724DOI
10.1080/10428190802657751Scopus ID
2-s2.0-61349195971 (requires institutional sign-in at Scopus site) 105 CitationsAbstract
This study was conducted to compare the presenting features and outcome of newly-diagnosed myeloma with and without extramedullary (EM) manifestations and to determine the optimum treatment. Seventy-five (16.3%) patients with EM involvement at diagnosis were compared with 384 cases without EM disease. EM patients had a more favourable International Staging System and a different distribution of myeloma isotypes. When adjusted according to the independent risk factors, patients in the EM group treated with chemotherapy alone had significantly shorter overall survival (OS) compared to those without EM disease receiving similar treatment. High-dose treatment (HDT) was associated with significantly improved OS in both groups; however, it had more impact on OS among EM group, overcoming the negative prognostic impact of presenting EM disease. Patients in the EM group treated with HDT have a similar outcome to those without EM manifestations treated with HDT. HDT should form an integral component of first-line treatment for patients with EM disease whenever possible.
Author List
Wu P, Davies FE, Boyd K, Thomas K, Dines S, Saso RM, Potter MN, Ethell ME, Shaw BE, Morgan GJAuthor
Bronwen E. Shaw PhD, MD Center Director, Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Aged, 80 and over
Antineoplastic Agents
Female
Humans
Male
Middle Aged
Multiple Myeloma
Neoplasm Staging
Risk Factors
Spinal Cord Diseases
Survival Rate
Treatment Outcome
