Paraskeletal and extramedullary plasmacytomas in multiple myeloma at diagnosis and at first relapse: 50-years of experience from an academic institution
Abstract From January 1970 to December 2018, 1304 patients were diagnosed with multiple myeloma (MM) at our institution and 256 (19.6%) had plasmacytomas (Ps) (paraskeletal –PPs- 17.6%, extramedullary –EMPs-1.9%). Patients with Ps had lower serum M-protein and less advanced ISS stage than those with...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Nature Publishing Group
2022-09-01
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| Series: | Blood Cancer Journal |
| Online Access: | https://doi.org/10.1038/s41408-022-00730-5 |
| _version_ | 1811267189106278400 |
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| author | Raquel Jiménez-Segura Laura Rosiñol Ma Teresa Cibeira Carlos Fernández de Larrea Natalia Tovar Luis Gerardo Rodríguez-Lobato Esther Bladé David F. Moreno Aina Oliver-Caldés Joan Bladé |
| author_facet | Raquel Jiménez-Segura Laura Rosiñol Ma Teresa Cibeira Carlos Fernández de Larrea Natalia Tovar Luis Gerardo Rodríguez-Lobato Esther Bladé David F. Moreno Aina Oliver-Caldés Joan Bladé |
| author_sort | Raquel Jiménez-Segura |
| collection | DOAJ |
| description | Abstract From January 1970 to December 2018, 1304 patients were diagnosed with multiple myeloma (MM) at our institution and 256 (19.6%) had plasmacytomas (Ps) (paraskeletal –PPs- 17.6%, extramedullary –EMPs-1.9%). Patients with Ps had lower serum M-protein and less advanced ISS stage than those without. At first relapse, 192 out of 967 patients (19.8%) developed Ps (PPs 14.6%, EMPs 5.1%). The only factor associated with Ps at relapse was the presence of Ps at diagnosis (46% vs 13%, p < 0.00001) with no impact with exposure to novel drugs or previous autologous stem-cell transplantation (ASCT). The median overall survival (OS) was 45, 44 and 20 months for patients without Ps, PPs and EMPs, respectively (p = 0.013). Patients with PPs who underwent ASCT had similar OS than those without Ps (98 vs. 113 months) and significantly longer than those with EMPs (98 vs 47 months, p = 0.006). In patients non-eligible for ASCT the presence of PPs or EMPs was associated with shorter OS compared with patients without Ps (32 vs. 24 vs. 6 months, p = 0.009). In the relapsed setting, a significant survival benefit was observed beyond the year 2000, but still with significant differences among patients without Ps, PPs and EMPs (37 vs 22 vs 16 months, p = 0.003). Importantly, rescue therapy with combinations of proteasome-inhibitors plus immunomodulatory drugs was associated with prolonged OS from first relapse (over 6 years), even in patients with EMPs. |
| first_indexed | 2024-04-12T20:57:55Z |
| format | Article |
| id | doaj.art-5e019032e0d549be9f149145a0b9acc3 |
| institution | Directory Open Access Journal |
| issn | 2044-5385 |
| language | English |
| last_indexed | 2024-04-12T20:57:55Z |
| publishDate | 2022-09-01 |
| publisher | Nature Publishing Group |
| record_format | Article |
| series | Blood Cancer Journal |
| spelling | doaj.art-5e019032e0d549be9f149145a0b9acc32022-12-22T03:16:55ZengNature Publishing GroupBlood Cancer Journal2044-53852022-09-011291810.1038/s41408-022-00730-5Paraskeletal and extramedullary plasmacytomas in multiple myeloma at diagnosis and at first relapse: 50-years of experience from an academic institutionRaquel Jiménez-Segura0Laura Rosiñol1Ma Teresa Cibeira2Carlos Fernández de Larrea3Natalia Tovar4Luis Gerardo Rodríguez-Lobato5Esther Bladé6David F. Moreno7Aina Oliver-Caldés8Joan Bladé9Hematology department, Amyloidosis and Myeloma Unit, Hospital Clínic de BarcelonaHematology department, Amyloidosis and Myeloma Unit, Hospital Clínic de BarcelonaHematology department, Amyloidosis and Myeloma Unit, Hospital Clínic de BarcelonaHematology department, Amyloidosis and Myeloma Unit, Hospital Clínic de BarcelonaHematology department, Amyloidosis and Myeloma Unit, Hospital Clínic de BarcelonaHematology department, Amyloidosis and Myeloma Unit, Hospital Clínic de BarcelonaHematology department, Amyloidosis and Myeloma Unit, Hospital Clínic de BarcelonaHematology department, Amyloidosis and Myeloma Unit, Hospital Clínic de BarcelonaHematology department, Amyloidosis and Myeloma Unit, Hospital Clínic de BarcelonaHematology department, Amyloidosis and Myeloma Unit, Hospital Clínic de BarcelonaAbstract From January 1970 to December 2018, 1304 patients were diagnosed with multiple myeloma (MM) at our institution and 256 (19.6%) had plasmacytomas (Ps) (paraskeletal –PPs- 17.6%, extramedullary –EMPs-1.9%). Patients with Ps had lower serum M-protein and less advanced ISS stage than those without. At first relapse, 192 out of 967 patients (19.8%) developed Ps (PPs 14.6%, EMPs 5.1%). The only factor associated with Ps at relapse was the presence of Ps at diagnosis (46% vs 13%, p < 0.00001) with no impact with exposure to novel drugs or previous autologous stem-cell transplantation (ASCT). The median overall survival (OS) was 45, 44 and 20 months for patients without Ps, PPs and EMPs, respectively (p = 0.013). Patients with PPs who underwent ASCT had similar OS than those without Ps (98 vs. 113 months) and significantly longer than those with EMPs (98 vs 47 months, p = 0.006). In patients non-eligible for ASCT the presence of PPs or EMPs was associated with shorter OS compared with patients without Ps (32 vs. 24 vs. 6 months, p = 0.009). In the relapsed setting, a significant survival benefit was observed beyond the year 2000, but still with significant differences among patients without Ps, PPs and EMPs (37 vs 22 vs 16 months, p = 0.003). Importantly, rescue therapy with combinations of proteasome-inhibitors plus immunomodulatory drugs was associated with prolonged OS from first relapse (over 6 years), even in patients with EMPs.https://doi.org/10.1038/s41408-022-00730-5 |
| spellingShingle | Raquel Jiménez-Segura Laura Rosiñol Ma Teresa Cibeira Carlos Fernández de Larrea Natalia Tovar Luis Gerardo Rodríguez-Lobato Esther Bladé David F. Moreno Aina Oliver-Caldés Joan Bladé Paraskeletal and extramedullary plasmacytomas in multiple myeloma at diagnosis and at first relapse: 50-years of experience from an academic institution Blood Cancer Journal |
| title | Paraskeletal and extramedullary plasmacytomas in multiple myeloma at diagnosis and at first relapse: 50-years of experience from an academic institution |
| title_full | Paraskeletal and extramedullary plasmacytomas in multiple myeloma at diagnosis and at first relapse: 50-years of experience from an academic institution |
| title_fullStr | Paraskeletal and extramedullary plasmacytomas in multiple myeloma at diagnosis and at first relapse: 50-years of experience from an academic institution |
| title_full_unstemmed | Paraskeletal and extramedullary plasmacytomas in multiple myeloma at diagnosis and at first relapse: 50-years of experience from an academic institution |
| title_short | Paraskeletal and extramedullary plasmacytomas in multiple myeloma at diagnosis and at first relapse: 50-years of experience from an academic institution |
| title_sort | paraskeletal and extramedullary plasmacytomas in multiple myeloma at diagnosis and at first relapse 50 years of experience from an academic institution |
| url | https://doi.org/10.1038/s41408-022-00730-5 |
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