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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

Overall survival of symptomatic MM patients with or without abnormal medullary lesions.
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fig3: Overall survival of symptomatic MM patients with or without abnormal medullary lesions.

Mentions: Twenty patients died over a median follow-up of 25.2 months. The Kaplan–Meier curves for OS of both groups are shown in Figure 3. Patients with abnormal medullary lesions showed a lower survival rate than those without such lesions, but the difference did not reach statistical significance (P=0.059). However, in multivariate Cox regression analysis, the presence of abnormal medullary lesions was shown to be an independent predictor even after adjustment by age, ISS 3 and high-risk CA, (hazard ratio 3.546; P=0.04; Table 4).


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)

Overall survival of symptomatic MM patients with or without abnormal medullary lesions.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig3: Overall survival of symptomatic MM patients with or without abnormal medullary lesions.
Mentions: Twenty patients died over a median follow-up of 25.2 months. The Kaplan–Meier curves for OS of both groups are shown in Figure 3. Patients with abnormal medullary lesions showed a lower survival rate than those without such lesions, but the difference did not reach statistical significance (P=0.059). However, in multivariate Cox regression analysis, the presence of abnormal medullary lesions was shown to be an independent predictor even after adjustment by age, ISS 3 and high-risk CA, (hazard ratio 3.546; P=0.04; Table 4).

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