Limits...
Clinical and prognostic significance of bone marrow abnormalities in the appendicular skeleton detected by low-dose whole-body multidetector computed tomography in patients with multiple myeloma.

Nishida Y, Matsue Y, Suehara Y, Fukumoto K, Fujisawa M, Takeuchi M, Ouchi E, Matsue K - Blood Cancer J (2015)

Bottom Line: Disease progression of MM was independently associated with high CTv on multivariate analysis.In symptomatic MM, the presence of abnormal medullary lesions was associated with increased incidence of high-risk cytogenetic abnormalities (34.4% vs 7.7%; P=0.002) and extramedullary disease (10.4% vs 0%; P=0.032).This study showed that CTv of AS by MDCT is correlated with disease progression of MM, and the presence of abnormal medullary lesions is a predictor for poor survival.

View Article: PubMed Central - PubMed

Affiliation: 1] Division of Hematology/Oncology, Department of Medicine, Kameda Medical Center, Kamogawa, Japan [2] Department of Hematology, Respiratory Medicine and Oncology, Division of Internal Medicine, Saga University, Saga, Japan.

ABSTRACT
Clinical significance of medullary abnormalities in the appendicular skeleton (AS) detected by low-dose whole-body multidetector computed tomography (MDCT) in patients with multiple myeloma (MM) was investigated. A total of 172 patients with monoclonal gammopathy of undetermined significance (MGUS) (n=17), smoldering MM (n=47) and symptomatic MM (n=108) underwent low-dose MDCT. CT values (CTv) of medullary density of AS⩾0 Hounsfield unit (HU) was considered as abnormal. Percentage of medullary abnormalities and the mean CTv of AS in patients with MGUS, smoldering MM and symptomatic MM were 18, 55 and 62% and -44.5 , -20.3 and 11.2 HU, respectively (P<0.001 and P<0.001). Disease progression of MM was independently associated with high CTv on multivariate analysis. In symptomatic MM, the presence of abnormal medullary lesions was associated with increased incidence of high-risk cytogenetic abnormalities (34.4% vs 7.7%; P=0.002) and extramedullary disease (10.4% vs 0%; P=0.032). It was also an independent poor prognostic predictor (hazard ratio 3.546, P=0.04). This study showed that CTv of AS by MDCT is correlated with disease progression of MM, and the presence of abnormal medullary lesions is a predictor for poor survival.

No MeSH data available.


Related in: MedlinePlus

Box plot of CTv in patients with MGUS, smoldering MM and symptomatic MM. ANOVA, analysis of variance.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4526783&req=5

fig2: Box plot of CTv in patients with MGUS, smoldering MM and symptomatic MM. ANOVA, analysis of variance.

Mentions: Table 1 shows the clinical characteristics and abnormal marrow lesions of AS in patients with MGUS, smoldering MM and symptomatic MM in this study. Age and sex were similar between the MGUS, smoldering MM and symptomatic MM groups. The prevalence of the IgG subtype was higher in MGUS compared with MM. The percentages of abnormal medullary lesions in AS in MGUS, smoldering MM and symptomatic MM were 17.6% (3/17), 27.7% (13/47) and 62.0% (67/108), respectively. Of these patients, the respective proportions of diffuse and focal patterns in abnormal lesions were 5.9% and 11.8% in MGUS, 10.6 and 44.7% in smoldering MM and 28.6% and 61.7% in symptomatic MM. Most of the patients with symptomatic MM were Durie–Salmon stage III, and half were ISS III. Figure 2 shows box plots of CTv in patients with MGUS, smoldering MM and symptomatic MM. The mean CTv in patients with MGUS, smoldering MM and symptomatic MM were –44.5 HU (–72.6 to –21.9), –20.3 HU (–42.9 to 0.7) and 11.5 HU (–12.5 to 43.4), respectively (P<0.001 by analysis of variance and P<0.001 for trend). To estimate independent relevance between CTv and clinical variables, backward Akaike Information Criterion was performed, and the results are shown in Table 2. The results showed that MGUS and smoldering MM were both independently associated with lower CTv compared with symptomatic MM.


Clinical and prognostic significance of bone marrow abnormalities in the appendicular skeleton detected by low-dose whole-body multidetector computed tomography in patients with multiple myeloma.

Nishida Y, Matsue Y, Suehara Y, Fukumoto K, Fujisawa M, Takeuchi M, Ouchi E, Matsue K - Blood Cancer J (2015)

Box plot of CTv in patients with MGUS, smoldering MM and symptomatic MM. ANOVA, analysis of variance.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4526783&req=5

fig2: Box plot of CTv in patients with MGUS, smoldering MM and symptomatic MM. ANOVA, analysis of variance.
Mentions: Table 1 shows the clinical characteristics and abnormal marrow lesions of AS in patients with MGUS, smoldering MM and symptomatic MM in this study. Age and sex were similar between the MGUS, smoldering MM and symptomatic MM groups. The prevalence of the IgG subtype was higher in MGUS compared with MM. The percentages of abnormal medullary lesions in AS in MGUS, smoldering MM and symptomatic MM were 17.6% (3/17), 27.7% (13/47) and 62.0% (67/108), respectively. Of these patients, the respective proportions of diffuse and focal patterns in abnormal lesions were 5.9% and 11.8% in MGUS, 10.6 and 44.7% in smoldering MM and 28.6% and 61.7% in symptomatic MM. Most of the patients with symptomatic MM were Durie–Salmon stage III, and half were ISS III. Figure 2 shows box plots of CTv in patients with MGUS, smoldering MM and symptomatic MM. The mean CTv in patients with MGUS, smoldering MM and symptomatic MM were –44.5 HU (–72.6 to –21.9), –20.3 HU (–42.9 to 0.7) and 11.5 HU (–12.5 to 43.4), respectively (P<0.001 by analysis of variance and P<0.001 for trend). To estimate independent relevance between CTv and clinical variables, backward Akaike Information Criterion was performed, and the results are shown in Table 2. The results showed that MGUS and smoldering MM were both independently associated with lower CTv compared with symptomatic MM.

Bottom Line: Disease progression of MM was independently associated with high CTv on multivariate analysis.In symptomatic MM, the presence of abnormal medullary lesions was associated with increased incidence of high-risk cytogenetic abnormalities (34.4% vs 7.7%; P=0.002) and extramedullary disease (10.4% vs 0%; P=0.032).This study showed that CTv of AS by MDCT is correlated with disease progression of MM, and the presence of abnormal medullary lesions is a predictor for poor survival.

View Article: PubMed Central - PubMed

Affiliation: 1] Division of Hematology/Oncology, Department of Medicine, Kameda Medical Center, Kamogawa, Japan [2] Department of Hematology, Respiratory Medicine and Oncology, Division of Internal Medicine, Saga University, Saga, Japan.

ABSTRACT
Clinical significance of medullary abnormalities in the appendicular skeleton (AS) detected by low-dose whole-body multidetector computed tomography (MDCT) in patients with multiple myeloma (MM) was investigated. A total of 172 patients with monoclonal gammopathy of undetermined significance (MGUS) (n=17), smoldering MM (n=47) and symptomatic MM (n=108) underwent low-dose MDCT. CT values (CTv) of medullary density of AS⩾0 Hounsfield unit (HU) was considered as abnormal. Percentage of medullary abnormalities and the mean CTv of AS in patients with MGUS, smoldering MM and symptomatic MM were 18, 55 and 62% and -44.5 , -20.3 and 11.2 HU, respectively (P<0.001 and P<0.001). Disease progression of MM was independently associated with high CTv on multivariate analysis. In symptomatic MM, the presence of abnormal medullary lesions was associated with increased incidence of high-risk cytogenetic abnormalities (34.4% vs 7.7%; P=0.002) and extramedullary disease (10.4% vs 0%; P=0.032). It was also an independent poor prognostic predictor (hazard ratio 3.546, P=0.04). This study showed that CTv of AS by MDCT is correlated with disease progression of MM, and the presence of abnormal medullary lesions is a predictor for poor survival.

No MeSH data available.


Related in: MedlinePlus