A real world multicenter retrospective study on extramedullary disease from Balkan Myeloma Study Group and Barcelona University: Analysis of parameters that improve outcome

dc.contributor.authorBeksaç, Meral
dc.contributor.authorSeval, Güldane Cengiz
dc.contributor.departmentDil ve Tarih-Coğrafya Fakültesitr_TR
dc.date.accessioned2020-02-14T09:18:19Z
dc.date.available2020-02-14T09:18:19Z
dc.date.issued2020
dc.description.abstractHere, we report the outcome of 226 myeloma patients presenting with extramedullary plasmacytoma or paraosseous involvement in a retrospective study conducted in 19 centers from 11 countries. Extramedullary disease was detected at diagnosis or relapse between January 2010 and November 2017. Extramedullary plasmacytoma and paraosseous involvement were observed in 130 patients at diagnosis (92 of 38) and in 96 at relapse (84 of 12). The median time from multiple myeloma diagnosis to the development of extramedullary disease was 25.1 months (range 3.1-106.3 months) in the relapse group (median follow up: 15 months). Imaging approach for extramedullary disease was computed tomography (n=133), positron emission tomography combined with computed tomography (n=50), or magnetic resonance imaging (n=35). The entire group received a median two lines of treatment and autologous stem cell transplantation (44%) following the diagnosis of extramedullary disease. Complete response was higher for paraosseous involvement versus extramedullary plasmacytoma at diagnosis (34.2% vs. 19.3%; P=NS.) and relapse (54.5% vs. 9%; P=0.001). Also paraosseous involvement patients had a better progression-free survival (PFS) when recognized at initial diagnosis of myeloma than at relapse (51.7 vs. 38.9 months). In addition, overall survival was better for paraosseous involvement compared to extramedullary plasmacytoma at diagnosis (not reached vs. 46.5 months). Extramedullary plasmacytoma at relapse had the worst prognosis with a PFS of 13.6 months and overall survival of 11.4 months. In the multivariate analysis, paraosseous involvement, extramedullary disease at diagnosis, International Staging System (ISS-I), and undergoing autologous stem cell transplantation improved overall survival independently. This cohort demonstrated that extramedullary disease benefits from front-line autologous stem cell transplantation and extramedullary plasmacytoma differs from paraosseous involvement in terms of rate and duration of response, with even worse outcomes when detected at relapse, constituting an unmet clinical need. © 2020 Ferrata Storti Foundationtr_TR
dc.description.indexScopus
dc.description.indexWos
dc.description.indexPubmed
dc.identifier.endpage208tr_TR
dc.identifier.issn/e-issn0390-6078
dc.identifier.issue1tr_TR
dc.identifier.startpage201tr_TR
dc.identifier.urihttps://doi.org/10.3324/haematol.2019.219295tr_TR
dc.identifier.urihttp://hdl.handle.net/20.500.12575/69514
dc.identifier.volume105tr_TR
dc.language.isoentr_TR
dc.relation.isversionof10.3324/haematol.2019.219295tr_TR
dc.relation.journalHaematologicatr_TR
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıtr_TR
dc.rightsCC0 1.0 Universal*
dc.rights.urihttp://creativecommons.org/publicdomain/zero/1.0/*
dc.titleA real world multicenter retrospective study on extramedullary disease from Balkan Myeloma Study Group and Barcelona University: Analysis of parameters that improve outcometr_TR
dc.typeArticletr_TR

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