Bone-Related Extramedullary Disease in Newly Diagnosed Myeloma Patients is an Independent Poor Prognostic Predictor
Background: Bone-related extramedullary disease (EMD-B) is mass of clonal plasma cells derived from adjacent bone lesions and has obvious heterogeneities in clinical outcomes. This retrospective study aims to evaluate the treatment outcomes and long-term prognosis of newly diagnosed myeloma patients...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-07-01
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| Series: | Clinical Medicine Insights: Oncology |
| Online Access: | https://doi.org/10.1177/11795549221109500 |
| _version_ | 1811218123096850432 |
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| author | Ying Wang Aijun Liu Tingting Xu Jiahui Yin Wenming Chen |
| author_facet | Ying Wang Aijun Liu Tingting Xu Jiahui Yin Wenming Chen |
| author_sort | Ying Wang |
| collection | DOAJ |
| description | Background: Bone-related extramedullary disease (EMD-B) is mass of clonal plasma cells derived from adjacent bone lesions and has obvious heterogeneities in clinical outcomes. This retrospective study aims to evaluate the treatment outcomes and long-term prognosis of newly diagnosed myeloma patients with EMD-B. Methods: This was a retrospective study conducted in Beijing Chaoyang Hospital from January 1, 2010 to December 31, 2019. Seventy-seven newly diagnosed multiple myeloma patients with EMD-B were selected. Propensity score matching (1:2) was used to match patients with and without EMD-B. After matching, 132 patients without extramedullary disease (non-EMD) were included in the study. All patients received bortezomib-based regimens as induction therapy. Results: After matching, baseline data of the 2 groups were comparable. The Cox regression analysis of patients with EMD-B showed that age, paravertebral lesions, and immunoglobulin D (IgD) type may have adverse effects on survival. Bone-related extramedullary disease at new diagnosis was a risk predictor of survival (hazard ration [HR] = 1.80, 95% confidence interval [CI]: 1.09-2.98, P = .022). The median survival time of the EMD-B group was significantly shorter than that of the non-EMD group (52 months vs 96 months, P = .043). Induction therapy did not show any significant differences in effectiveness between the 2 groups. Autologous stem cell transplantation (ASCT) significantly increased complete remission rate of patients with EMD-B (EMD-B vs non-EMD: no ASCT 15.7% vs 31.9%, P = .035; ASCT 42.3% vs 48.8%, P = .626) and improved their median overall survival rate (EMD-B vs non-EMD: no ASCT 49 months vs 75 months, P = .003; ASCT not reached vs 96 months, P = .505). Conclusions: This study demonstrated that newly diagnosed myeloma patients with EMD-B had poor outcomes, which could be improved by ASCT. |
| first_indexed | 2024-04-12T07:04:15Z |
| format | Article |
| id | doaj.art-df76a62d9b1f46a7918be50d98cbe32b |
| institution | Directory Open Access Journal |
| issn | 1179-5549 |
| language | English |
| last_indexed | 2024-04-12T07:04:15Z |
| publishDate | 2022-07-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical Medicine Insights: Oncology |
| spelling | doaj.art-df76a62d9b1f46a7918be50d98cbe32b2022-12-22T03:42:54ZengSAGE PublishingClinical Medicine Insights: Oncology1179-55492022-07-011610.1177/11795549221109500Bone-Related Extramedullary Disease in Newly Diagnosed Myeloma Patients is an Independent Poor Prognostic PredictorYing WangAijun LiuTingting XuJiahui YinWenming ChenBackground: Bone-related extramedullary disease (EMD-B) is mass of clonal plasma cells derived from adjacent bone lesions and has obvious heterogeneities in clinical outcomes. This retrospective study aims to evaluate the treatment outcomes and long-term prognosis of newly diagnosed myeloma patients with EMD-B. Methods: This was a retrospective study conducted in Beijing Chaoyang Hospital from January 1, 2010 to December 31, 2019. Seventy-seven newly diagnosed multiple myeloma patients with EMD-B were selected. Propensity score matching (1:2) was used to match patients with and without EMD-B. After matching, 132 patients without extramedullary disease (non-EMD) were included in the study. All patients received bortezomib-based regimens as induction therapy. Results: After matching, baseline data of the 2 groups were comparable. The Cox regression analysis of patients with EMD-B showed that age, paravertebral lesions, and immunoglobulin D (IgD) type may have adverse effects on survival. Bone-related extramedullary disease at new diagnosis was a risk predictor of survival (hazard ration [HR] = 1.80, 95% confidence interval [CI]: 1.09-2.98, P = .022). The median survival time of the EMD-B group was significantly shorter than that of the non-EMD group (52 months vs 96 months, P = .043). Induction therapy did not show any significant differences in effectiveness between the 2 groups. Autologous stem cell transplantation (ASCT) significantly increased complete remission rate of patients with EMD-B (EMD-B vs non-EMD: no ASCT 15.7% vs 31.9%, P = .035; ASCT 42.3% vs 48.8%, P = .626) and improved their median overall survival rate (EMD-B vs non-EMD: no ASCT 49 months vs 75 months, P = .003; ASCT not reached vs 96 months, P = .505). Conclusions: This study demonstrated that newly diagnosed myeloma patients with EMD-B had poor outcomes, which could be improved by ASCT.https://doi.org/10.1177/11795549221109500 |
| spellingShingle | Ying Wang Aijun Liu Tingting Xu Jiahui Yin Wenming Chen Bone-Related Extramedullary Disease in Newly Diagnosed Myeloma Patients is an Independent Poor Prognostic Predictor Clinical Medicine Insights: Oncology |
| title | Bone-Related Extramedullary Disease in Newly Diagnosed Myeloma Patients is an Independent Poor Prognostic Predictor |
| title_full | Bone-Related Extramedullary Disease in Newly Diagnosed Myeloma Patients is an Independent Poor Prognostic Predictor |
| title_fullStr | Bone-Related Extramedullary Disease in Newly Diagnosed Myeloma Patients is an Independent Poor Prognostic Predictor |
| title_full_unstemmed | Bone-Related Extramedullary Disease in Newly Diagnosed Myeloma Patients is an Independent Poor Prognostic Predictor |
| title_short | Bone-Related Extramedullary Disease in Newly Diagnosed Myeloma Patients is an Independent Poor Prognostic Predictor |
| title_sort | bone related extramedullary disease in newly diagnosed myeloma patients is an independent poor prognostic predictor |
| url | https://doi.org/10.1177/11795549221109500 |
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