Central Nervous System Involvement by Multiple Myeloma: a Multi-Institutional Retrospective Study of 172 Patients in daily clinical practice
Identifieur interne : 001E18 ( Pmc/Curation ); précédent : 001E17; suivant : 001E19Central Nervous System Involvement by Multiple Myeloma: a Multi-Institutional Retrospective Study of 172 Patients in daily clinical practice
Auteurs : Artur Jurczyszyn [Pologne] ; Norbert Grzasko [Pologne] ; Alessandro Gozzetti [Italie] ; Jacek Czepiel [Pologne] ; Alfonso Cerase [Italie] ; Vania Hungria [Brésil] ; Edvan Crusoe [Brésil] ; Ana Luiza Miranda Silva Diaz [Brésil] ; Ravi Vij [États-Unis] ; Mark A. Fiala [États-Unis] ; Jo Caers [Belgique] ; Leo Rasche [Allemagne] ; Ajay K. Nooka [États-Unis] ; Sagar Lonial [États-Unis] ; David H. Vesole [États-Unis] ; Sandhya Philip [États-Unis] ; Shane Gangatharan [Australie] ; Agnieszka Druzd-Sitek [Pologne] ; Jan Walewski [Pologne] ; Alessandro Corso [Italie] ; Federica Cocito [Italie] ; Marie-Christine M. Vekemans [Belgique] ; Erden Atilla [Turquie] ; Meral Beksac [Turquie] ; Xavier Leleu [France] ; Julio Davila [Espagne] ; Ashraf Badros [États-Unis] ; Ekta Aneja [États-Unis] ; Niels Abildgaard [Danemark] ; Efstathios Kastritis [Grèce] ; Dorotea Fantl [Argentine] ; Natalia Schutz [Argentine] ; Tomas Pika [République tchèque] ; Aleksandra Butrym [Pologne] ; Magdalena Olszewska-Szopa [Pologne] ; Lidia Usnarska-Zubkiewicz [Pologne] ; Saad Usmani [États-Unis] ; Hareth Nahi [Suède] ; Chor S. Chim [Hong Kong] ; Chaim Shustik [Canada] ; Krzysztof Madry [Pologne] ; Suzanne Lentzsch [États-Unis] ; Alina Swiderska [Pologne] ; Grzegorz Helbig [Pologne] ; Renata Guzicka-Kazimierczak [Pologne] ; Nikoletta Lendvai [États-Unis] ; Anders Waage [Norvège] ; Kristian T. Andersen [Danemark] ; Hirokazu Murakami [Japon] ; Sonja Zweegman [Pays-Bas] ; Jorge J. Castillo [États-Unis]Source :
- American journal of hematology [ 0361-8609 ] ; 2016.
Abstract
The multicenter retrospective study conducted in 38 centers from 20 countries including 172 adult patients with CNS MM aimed to describe the clinical and pathological characteristics and outcomes of patients with multiple myeloma (MM) involving the central nervous system (CNS). Univariate and multivariate analyses were performed to identify prognostic factors for survival. The median time from MM diagnosis to CNS MM diagnosis was 3 years. Thirty-eight patients (22%) were diagnosed with CNS involvement at the time of initial MM diagnosis and 134 (78%) at relapse/progression. Upon diagnosis of CNS MM, 97% patients received initial therapy for CNS disease, of which 76% received systemic therapy, 36% radiotherapy and 32% intrathecal therapy. After a median follow-up of 3.5 years, the median overall survival (OS) from the onset of CNS involvement for the entire group was 7 months. Untreated and treated patients had median OS of 2 and 8 months, respectively (p<0.001). At least one previous line of therapy for MM before the diagnosis of CNS disease and >1 cytogenetic abnormality detected by FISH were independently associated with worse OS. The median OS for patients with 0, 1 and 2 of these risk factors were 25 months, 5.5 months and 2 months, respectively (p<0.001). Neurological manifestations, not considered chemotherapy-related, observed at any time after initial diagnosis of MM should raise a suspicion of CNS involvement. Although prognosis is generally poor, the survival of previously untreated patients and patients with favorable cytogenetic profile might be prolonged due to systemic treatment and/or radiotherapy.
Url:
DOI: 10.1002/ajh.24351
PubMed: 26955792
PubMed Central: 5502095
Links toward previous steps (curation, corpus...)
- to stream Pmc, to step Corpus: Pour aller vers cette notice dans l'étape Curation :001F64
Links to Exploration step
PMC:5502095Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Central Nervous System Involvement by Multiple Myeloma: a Multi-Institutional Retrospective Study of 172 Patients in daily clinical practice</title>
<author><name sortKey="Jurczyszyn, Artur" sort="Jurczyszyn, Artur" uniqKey="Jurczyszyn A" first="Artur" last="Jurczyszyn">Artur Jurczyszyn</name>
<affiliation wicri:level="1"><nlm:aff id="A1">Jagiellonian University Medical College, Cracow, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Jagiellonian University Medical College, Cracow</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Grzasko, Norbert" sort="Grzasko, Norbert" uniqKey="Grzasko N" first="Norbert" last="Grzasko">Norbert Grzasko</name>
<affiliation wicri:level="1"><nlm:aff id="A2">Medical University of Lublin, Department of Hematooncology and Bone Marrow Transplantation, Lublin, Poland; St. John’s Cancer Center, Department of Hematology, Lublin, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Medical University of Lublin, Department of Hematooncology and Bone Marrow Transplantation, Lublin, Poland; St. John’s Cancer Center, Department of Hematology, Lublin</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Gozzetti, Alessandro" sort="Gozzetti, Alessandro" uniqKey="Gozzetti A" first="Alessandro" last="Gozzetti">Alessandro Gozzetti</name>
<affiliation wicri:level="1"><nlm:aff id="A3">Azienda Ospedaliera Universitaria Senese, Siena, Italy</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Azienda Ospedaliera Universitaria Senese, Siena</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Czepiel, Jacek" sort="Czepiel, Jacek" uniqKey="Czepiel J" first="Jacek" last="Czepiel">Jacek Czepiel</name>
<affiliation wicri:level="1"><nlm:aff id="A1">Jagiellonian University Medical College, Cracow, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Jagiellonian University Medical College, Cracow</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Cerase, Alfonso" sort="Cerase, Alfonso" uniqKey="Cerase A" first="Alfonso" last="Cerase">Alfonso Cerase</name>
<affiliation wicri:level="1"><nlm:aff id="A3">Azienda Ospedaliera Universitaria Senese, Siena, Italy</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Azienda Ospedaliera Universitaria Senese, Siena</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Hungria, Vania" sort="Hungria, Vania" uniqKey="Hungria V" first="Vania" last="Hungria">Vania Hungria</name>
<affiliation wicri:level="1"><nlm:aff id="A4">Santa Casa Medical School, Sao Paulo, Brazil</nlm:aff>
<country xml:lang="fr">Brésil</country>
<wicri:regionArea>Santa Casa Medical School, Sao Paulo</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Crusoe, Edvan" sort="Crusoe, Edvan" uniqKey="Crusoe E" first="Edvan" last="Crusoe">Edvan Crusoe</name>
<affiliation wicri:level="1"><nlm:aff id="A4">Santa Casa Medical School, Sao Paulo, Brazil</nlm:aff>
<country xml:lang="fr">Brésil</country>
<wicri:regionArea>Santa Casa Medical School, Sao Paulo</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Diaz, Ana Luiza Miranda Silva" sort="Diaz, Ana Luiza Miranda Silva" uniqKey="Diaz A" first="Ana Luiza Miranda Silva" last="Diaz">Ana Luiza Miranda Silva Diaz</name>
<affiliation wicri:level="1"><nlm:aff id="A4">Santa Casa Medical School, Sao Paulo, Brazil</nlm:aff>
<country xml:lang="fr">Brésil</country>
<wicri:regionArea>Santa Casa Medical School, Sao Paulo</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Vij, Ravi" sort="Vij, Ravi" uniqKey="Vij R" first="Ravi" last="Vij">Ravi Vij</name>
<affiliation wicri:level="1"><nlm:aff id="A5">Washington University School of Medicine, St. Louis, Missouri, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Washington University School of Medicine, St. Louis, Missouri</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Fiala, Mark A" sort="Fiala, Mark A" uniqKey="Fiala M" first="Mark A." last="Fiala">Mark A. Fiala</name>
<affiliation wicri:level="1"><nlm:aff id="A5">Washington University School of Medicine, St. Louis, Missouri, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Washington University School of Medicine, St. Louis, Missouri</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Caers, Jo" sort="Caers, Jo" uniqKey="Caers J" first="Jo" last="Caers">Jo Caers</name>
<affiliation wicri:level="1"><nlm:aff id="A6">Centre Hospitalier Universitaire de Liege, Liege, Belgium</nlm:aff>
<country xml:lang="fr">Belgique</country>
<wicri:regionArea>Centre Hospitalier Universitaire de Liege, Liege</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Rasche, Leo" sort="Rasche, Leo" uniqKey="Rasche L" first="Leo" last="Rasche">Leo Rasche</name>
<affiliation wicri:level="1"><nlm:aff id="A7">University Hospital Wuerzburg, Wuerzburg, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>University Hospital Wuerzburg, Wuerzburg</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Nooka, Ajay K" sort="Nooka, Ajay K" uniqKey="Nooka A" first="Ajay K." last="Nooka">Ajay K. Nooka</name>
<affiliation wicri:level="1"><nlm:aff id="A8">Winship Cancer Institute, Emory University, Atlanta, Georgia, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Winship Cancer Institute, Emory University, Atlanta, Georgia</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Lonial, Sagar" sort="Lonial, Sagar" uniqKey="Lonial S" first="Sagar" last="Lonial">Sagar Lonial</name>
<affiliation wicri:level="1"><nlm:aff id="A8">Winship Cancer Institute, Emory University, Atlanta, Georgia, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Winship Cancer Institute, Emory University, Atlanta, Georgia</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Vesole, David H" sort="Vesole, David H" uniqKey="Vesole D" first="David H." last="Vesole">David H. Vesole</name>
<affiliation wicri:level="1"><nlm:aff id="A9">John Theurer Cancer Center at Hackensack UMC, New Jersey, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>John Theurer Cancer Center at Hackensack UMC, New Jersey</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Philip, Sandhya" sort="Philip, Sandhya" uniqKey="Philip S" first="Sandhya" last="Philip">Sandhya Philip</name>
<affiliation wicri:level="1"><nlm:aff id="A9">John Theurer Cancer Center at Hackensack UMC, New Jersey, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>John Theurer Cancer Center at Hackensack UMC, New Jersey</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Gangatharan, Shane" sort="Gangatharan, Shane" uniqKey="Gangatharan S" first="Shane" last="Gangatharan">Shane Gangatharan</name>
<affiliation wicri:level="1"><nlm:aff id="A10">Fremantle Hospital, Fremantle, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Fremantle Hospital, Fremantle</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Druzd Sitek, Agnieszka" sort="Druzd Sitek, Agnieszka" uniqKey="Druzd Sitek A" first="Agnieszka" last="Druzd-Sitek">Agnieszka Druzd-Sitek</name>
<affiliation wicri:level="1"><nlm:aff id="A11">Maria Sklodowska-Curie Institute – Oncology Center, Warsaw, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Maria Sklodowska-Curie Institute – Oncology Center, Warsaw</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Walewski, Jan" sort="Walewski, Jan" uniqKey="Walewski J" first="Jan" last="Walewski">Jan Walewski</name>
<affiliation wicri:level="1"><nlm:aff id="A11">Maria Sklodowska-Curie Institute – Oncology Center, Warsaw, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Maria Sklodowska-Curie Institute – Oncology Center, Warsaw</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Corso, Alessandro" sort="Corso, Alessandro" uniqKey="Corso A" first="Alessandro" last="Corso">Alessandro Corso</name>
<affiliation wicri:level="1"><nlm:aff id="A12">Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Cocito, Federica" sort="Cocito, Federica" uniqKey="Cocito F" first="Federica" last="Cocito">Federica Cocito</name>
<affiliation wicri:level="1"><nlm:aff id="A12">Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Vekemans, Marie Christine M" sort="Vekemans, Marie Christine M" uniqKey="Vekemans M" first="Marie-Christine M." last="Vekemans">Marie-Christine M. Vekemans</name>
<affiliation wicri:level="1"><nlm:aff id="A13">Cliniques Universitaires Saint-Luc, Brussels, Belgium</nlm:aff>
<country xml:lang="fr">Belgique</country>
<wicri:regionArea>Cliniques Universitaires Saint-Luc, Brussels</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Atilla, Erden" sort="Atilla, Erden" uniqKey="Atilla E" first="Erden" last="Atilla">Erden Atilla</name>
<affiliation wicri:level="1"><nlm:aff id="A14">Ankara University Medical School, Ankara, Turkey</nlm:aff>
<country xml:lang="fr">Turquie</country>
<wicri:regionArea>Ankara University Medical School, Ankara</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Beksac, Meral" sort="Beksac, Meral" uniqKey="Beksac M" first="Meral" last="Beksac">Meral Beksac</name>
<affiliation wicri:level="1"><nlm:aff id="A14">Ankara University Medical School, Ankara, Turkey</nlm:aff>
<country xml:lang="fr">Turquie</country>
<wicri:regionArea>Ankara University Medical School, Ankara</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Leleu, Xavier" sort="Leleu, Xavier" uniqKey="Leleu X" first="Xavier" last="Leleu">Xavier Leleu</name>
<affiliation wicri:level="1"><nlm:aff id="A15">Hospital Huriez, Lille, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Hospital Huriez, Lille</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Davila, Julio" sort="Davila, Julio" uniqKey="Davila J" first="Julio" last="Davila">Julio Davila</name>
<affiliation wicri:level="1"><nlm:aff id="A16">Hospital Universitario de Salamanca, Salamanca, Spain</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Hospital Universitario de Salamanca, Salamanca</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Badros, Ashraf" sort="Badros, Ashraf" uniqKey="Badros A" first="Ashraf" last="Badros">Ashraf Badros</name>
<affiliation wicri:level="1"><nlm:aff id="A17">University of Maryland Medical Center, Baltimore, Maryland, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>University of Maryland Medical Center, Baltimore, Maryland</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Aneja, Ekta" sort="Aneja, Ekta" uniqKey="Aneja E" first="Ekta" last="Aneja">Ekta Aneja</name>
<affiliation wicri:level="1"><nlm:aff id="A18">Weill Cornell Medical College, New York, New York, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Weill Cornell Medical College, New York, New York</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Abildgaard, Niels" sort="Abildgaard, Niels" uniqKey="Abildgaard N" first="Niels" last="Abildgaard">Niels Abildgaard</name>
<affiliation wicri:level="1"><nlm:aff id="A19">Odense University Hospital, Odense, Denmark</nlm:aff>
<country xml:lang="fr">Danemark</country>
<wicri:regionArea>Odense University Hospital, Odense</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Kastritis, Efstathios" sort="Kastritis, Efstathios" uniqKey="Kastritis E" first="Efstathios" last="Kastritis">Efstathios Kastritis</name>
<affiliation wicri:level="1"><nlm:aff id="A20">National and Kapodistrian University of Athens, Athens, Greece</nlm:aff>
<country xml:lang="fr">Grèce</country>
<wicri:regionArea>National and Kapodistrian University of Athens, Athens</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Fantl, Dorotea" sort="Fantl, Dorotea" uniqKey="Fantl D" first="Dorotea" last="Fantl">Dorotea Fantl</name>
<affiliation wicri:level="1"><nlm:aff id="A21">Hospital Italiano de Buenos Aires, Buenos Aires, Argentina</nlm:aff>
<country xml:lang="fr">Argentine</country>
<wicri:regionArea>Hospital Italiano de Buenos Aires, Buenos Aires</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Schutz, Natalia" sort="Schutz, Natalia" uniqKey="Schutz N" first="Natalia" last="Schutz">Natalia Schutz</name>
<affiliation wicri:level="1"><nlm:aff id="A21">Hospital Italiano de Buenos Aires, Buenos Aires, Argentina</nlm:aff>
<country xml:lang="fr">Argentine</country>
<wicri:regionArea>Hospital Italiano de Buenos Aires, Buenos Aires</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Pika, Tomas" sort="Pika, Tomas" uniqKey="Pika T" first="Tomas" last="Pika">Tomas Pika</name>
<affiliation wicri:level="1"><nlm:aff id="A22">University Hospital Olomouc, Olomouc, Czech Republic</nlm:aff>
<country xml:lang="fr">République tchèque</country>
<wicri:regionArea>University Hospital Olomouc, Olomouc</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Butrym, Aleksandra" sort="Butrym, Aleksandra" uniqKey="Butrym A" first="Aleksandra" last="Butrym">Aleksandra Butrym</name>
<affiliation wicri:level="1"><nlm:aff id="A23">Wroclaw Medical University, Wroclaw, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Wroclaw Medical University, Wroclaw</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Olszewska Szopa, Magdalena" sort="Olszewska Szopa, Magdalena" uniqKey="Olszewska Szopa M" first="Magdalena" last="Olszewska-Szopa">Magdalena Olszewska-Szopa</name>
<affiliation wicri:level="1"><nlm:aff id="A23">Wroclaw Medical University, Wroclaw, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Wroclaw Medical University, Wroclaw</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Usnarska Zubkiewicz, Lidia" sort="Usnarska Zubkiewicz, Lidia" uniqKey="Usnarska Zubkiewicz L" first="Lidia" last="Usnarska-Zubkiewicz">Lidia Usnarska-Zubkiewicz</name>
<affiliation wicri:level="1"><nlm:aff id="A23">Wroclaw Medical University, Wroclaw, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Wroclaw Medical University, Wroclaw</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Usmani, Saad" sort="Usmani, Saad" uniqKey="Usmani S" first="Saad" last="Usmani">Saad Usmani</name>
<affiliation wicri:level="1"><nlm:aff id="A24">Levine Cancer Institute/Carolinas HealthCare System, Charlotte, NC, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Levine Cancer Institute/Carolinas HealthCare System, Charlotte, NC</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Nahi, Hareth" sort="Nahi, Hareth" uniqKey="Nahi H" first="Hareth" last="Nahi">Hareth Nahi</name>
<affiliation wicri:level="1"><nlm:aff id="A25">Karolinska University Hospital, Stockholm, Sweden</nlm:aff>
<country xml:lang="fr">Suède</country>
<wicri:regionArea>Karolinska University Hospital, Stockholm</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Chim, Chor S" sort="Chim, Chor S" uniqKey="Chim C" first="Chor S" last="Chim">Chor S. Chim</name>
<affiliation wicri:level="1"><nlm:aff id="A26">Queen Mary Hospital, University of Hong Kong, Hong Kong</nlm:aff>
<country xml:lang="fr">Hong Kong</country>
<wicri:regionArea>Queen Mary Hospital, University of Hong Kong</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Shustik, Chaim" sort="Shustik, Chaim" uniqKey="Shustik C" first="Chaim" last="Shustik">Chaim Shustik</name>
<affiliation wicri:level="1"><nlm:aff id="A27">Royal Victoria Hospital, McGill University, Montreal, Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Royal Victoria Hospital, McGill University, Montreal</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Madry, Krzysztof" sort="Madry, Krzysztof" uniqKey="Madry K" first="Krzysztof" last="Madry">Krzysztof Madry</name>
<affiliation wicri:level="1"><nlm:aff id="A28">Medical University, Warsaw, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Medical University, Warsaw</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Lentzsch, Suzanne" sort="Lentzsch, Suzanne" uniqKey="Lentzsch S" first="Suzanne" last="Lentzsch">Suzanne Lentzsch</name>
<affiliation wicri:level="1"><nlm:aff id="A29">Columbia University Medical Center, New York, New York, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Columbia University Medical Center, New York, New York</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Swiderska, Alina" sort="Swiderska, Alina" uniqKey="Swiderska A" first="Alina" last="Swiderska">Alina Swiderska</name>
<affiliation wicri:level="1"><nlm:aff id="A30">Provincial Hospital, Zielona Gora, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Provincial Hospital, Zielona Gora</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Helbig, Grzegorz" sort="Helbig, Grzegorz" uniqKey="Helbig G" first="Grzegorz" last="Helbig">Grzegorz Helbig</name>
<affiliation wicri:level="1"><nlm:aff id="A31">Silesian Medical University, Katowice, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Silesian Medical University, Katowice</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Guzicka Kazimierczak, Renata" sort="Guzicka Kazimierczak, Renata" uniqKey="Guzicka Kazimierczak R" first="Renata" last="Guzicka-Kazimierczak">Renata Guzicka-Kazimierczak</name>
<affiliation wicri:level="1"><nlm:aff id="A32">Pomeranian Medical University, Szczecin, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Pomeranian Medical University, Szczecin</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Lendvai, Nikoletta" sort="Lendvai, Nikoletta" uniqKey="Lendvai N" first="Nikoletta" last="Lendvai">Nikoletta Lendvai</name>
<affiliation wicri:level="1"><nlm:aff id="A33">Memorial Sloan-Kettering Cancer Center, New York, New York, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Memorial Sloan-Kettering Cancer Center, New York, New York</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Waage, Anders" sort="Waage, Anders" uniqKey="Waage A" first="Anders" last="Waage">Anders Waage</name>
<affiliation wicri:level="1"><nlm:aff id="A34">Norwegian University of Science and Technology, Trondheim, Norway</nlm:aff>
<country xml:lang="fr">Norvège</country>
<wicri:regionArea>Norwegian University of Science and Technology, Trondheim</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Andersen, Kristian T" sort="Andersen, Kristian T" uniqKey="Andersen K" first="Kristian T." last="Andersen">Kristian T. Andersen</name>
<affiliation wicri:level="1"><nlm:aff id="A35">Vejle Hospital, Vejle, Denmark</nlm:aff>
<country xml:lang="fr">Danemark</country>
<wicri:regionArea>Vejle Hospital, Vejle</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Murakami, Hirokazu" sort="Murakami, Hirokazu" uniqKey="Murakami H" first="Hirokazu" last="Murakami">Hirokazu Murakami</name>
<affiliation wicri:level="1"><nlm:aff id="A36">Gunma University Graduate School of Health Sciences, Gunma, Japan</nlm:aff>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Gunma University Graduate School of Health Sciences, Gunma</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Zweegman, Sonja" sort="Zweegman, Sonja" uniqKey="Zweegman S" first="Sonja" last="Zweegman">Sonja Zweegman</name>
<affiliation wicri:level="1"><nlm:aff id="A37">VU University Medical Center, Amsterdam, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>VU University Medical Center, Amsterdam</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Castillo, Jorge J" sort="Castillo, Jorge J" uniqKey="Castillo J" first="Jorge J." last="Castillo">Jorge J. Castillo</name>
<affiliation wicri:level="1"><nlm:aff id="A38">Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts</wicri:regionArea>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">26955792</idno>
<idno type="pmc">5502095</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5502095</idno>
<idno type="RBID">PMC:5502095</idno>
<idno type="doi">10.1002/ajh.24351</idno>
<date when="2016">2016</date>
<idno type="wicri:Area/Pmc/Corpus">001F64</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001F64</idno>
<idno type="wicri:Area/Pmc/Curation">001E18</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001E18</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Central Nervous System Involvement by Multiple Myeloma: a Multi-Institutional Retrospective Study of 172 Patients in daily clinical practice</title>
<author><name sortKey="Jurczyszyn, Artur" sort="Jurczyszyn, Artur" uniqKey="Jurczyszyn A" first="Artur" last="Jurczyszyn">Artur Jurczyszyn</name>
<affiliation wicri:level="1"><nlm:aff id="A1">Jagiellonian University Medical College, Cracow, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Jagiellonian University Medical College, Cracow</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Grzasko, Norbert" sort="Grzasko, Norbert" uniqKey="Grzasko N" first="Norbert" last="Grzasko">Norbert Grzasko</name>
<affiliation wicri:level="1"><nlm:aff id="A2">Medical University of Lublin, Department of Hematooncology and Bone Marrow Transplantation, Lublin, Poland; St. John’s Cancer Center, Department of Hematology, Lublin, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Medical University of Lublin, Department of Hematooncology and Bone Marrow Transplantation, Lublin, Poland; St. John’s Cancer Center, Department of Hematology, Lublin</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Gozzetti, Alessandro" sort="Gozzetti, Alessandro" uniqKey="Gozzetti A" first="Alessandro" last="Gozzetti">Alessandro Gozzetti</name>
<affiliation wicri:level="1"><nlm:aff id="A3">Azienda Ospedaliera Universitaria Senese, Siena, Italy</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Azienda Ospedaliera Universitaria Senese, Siena</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Czepiel, Jacek" sort="Czepiel, Jacek" uniqKey="Czepiel J" first="Jacek" last="Czepiel">Jacek Czepiel</name>
<affiliation wicri:level="1"><nlm:aff id="A1">Jagiellonian University Medical College, Cracow, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Jagiellonian University Medical College, Cracow</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Cerase, Alfonso" sort="Cerase, Alfonso" uniqKey="Cerase A" first="Alfonso" last="Cerase">Alfonso Cerase</name>
<affiliation wicri:level="1"><nlm:aff id="A3">Azienda Ospedaliera Universitaria Senese, Siena, Italy</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Azienda Ospedaliera Universitaria Senese, Siena</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Hungria, Vania" sort="Hungria, Vania" uniqKey="Hungria V" first="Vania" last="Hungria">Vania Hungria</name>
<affiliation wicri:level="1"><nlm:aff id="A4">Santa Casa Medical School, Sao Paulo, Brazil</nlm:aff>
<country xml:lang="fr">Brésil</country>
<wicri:regionArea>Santa Casa Medical School, Sao Paulo</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Crusoe, Edvan" sort="Crusoe, Edvan" uniqKey="Crusoe E" first="Edvan" last="Crusoe">Edvan Crusoe</name>
<affiliation wicri:level="1"><nlm:aff id="A4">Santa Casa Medical School, Sao Paulo, Brazil</nlm:aff>
<country xml:lang="fr">Brésil</country>
<wicri:regionArea>Santa Casa Medical School, Sao Paulo</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Diaz, Ana Luiza Miranda Silva" sort="Diaz, Ana Luiza Miranda Silva" uniqKey="Diaz A" first="Ana Luiza Miranda Silva" last="Diaz">Ana Luiza Miranda Silva Diaz</name>
<affiliation wicri:level="1"><nlm:aff id="A4">Santa Casa Medical School, Sao Paulo, Brazil</nlm:aff>
<country xml:lang="fr">Brésil</country>
<wicri:regionArea>Santa Casa Medical School, Sao Paulo</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Vij, Ravi" sort="Vij, Ravi" uniqKey="Vij R" first="Ravi" last="Vij">Ravi Vij</name>
<affiliation wicri:level="1"><nlm:aff id="A5">Washington University School of Medicine, St. Louis, Missouri, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Washington University School of Medicine, St. Louis, Missouri</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Fiala, Mark A" sort="Fiala, Mark A" uniqKey="Fiala M" first="Mark A." last="Fiala">Mark A. Fiala</name>
<affiliation wicri:level="1"><nlm:aff id="A5">Washington University School of Medicine, St. Louis, Missouri, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Washington University School of Medicine, St. Louis, Missouri</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Caers, Jo" sort="Caers, Jo" uniqKey="Caers J" first="Jo" last="Caers">Jo Caers</name>
<affiliation wicri:level="1"><nlm:aff id="A6">Centre Hospitalier Universitaire de Liege, Liege, Belgium</nlm:aff>
<country xml:lang="fr">Belgique</country>
<wicri:regionArea>Centre Hospitalier Universitaire de Liege, Liege</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Rasche, Leo" sort="Rasche, Leo" uniqKey="Rasche L" first="Leo" last="Rasche">Leo Rasche</name>
<affiliation wicri:level="1"><nlm:aff id="A7">University Hospital Wuerzburg, Wuerzburg, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>University Hospital Wuerzburg, Wuerzburg</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Nooka, Ajay K" sort="Nooka, Ajay K" uniqKey="Nooka A" first="Ajay K." last="Nooka">Ajay K. Nooka</name>
<affiliation wicri:level="1"><nlm:aff id="A8">Winship Cancer Institute, Emory University, Atlanta, Georgia, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Winship Cancer Institute, Emory University, Atlanta, Georgia</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Lonial, Sagar" sort="Lonial, Sagar" uniqKey="Lonial S" first="Sagar" last="Lonial">Sagar Lonial</name>
<affiliation wicri:level="1"><nlm:aff id="A8">Winship Cancer Institute, Emory University, Atlanta, Georgia, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Winship Cancer Institute, Emory University, Atlanta, Georgia</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Vesole, David H" sort="Vesole, David H" uniqKey="Vesole D" first="David H." last="Vesole">David H. Vesole</name>
<affiliation wicri:level="1"><nlm:aff id="A9">John Theurer Cancer Center at Hackensack UMC, New Jersey, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>John Theurer Cancer Center at Hackensack UMC, New Jersey</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Philip, Sandhya" sort="Philip, Sandhya" uniqKey="Philip S" first="Sandhya" last="Philip">Sandhya Philip</name>
<affiliation wicri:level="1"><nlm:aff id="A9">John Theurer Cancer Center at Hackensack UMC, New Jersey, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>John Theurer Cancer Center at Hackensack UMC, New Jersey</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Gangatharan, Shane" sort="Gangatharan, Shane" uniqKey="Gangatharan S" first="Shane" last="Gangatharan">Shane Gangatharan</name>
<affiliation wicri:level="1"><nlm:aff id="A10">Fremantle Hospital, Fremantle, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Fremantle Hospital, Fremantle</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Druzd Sitek, Agnieszka" sort="Druzd Sitek, Agnieszka" uniqKey="Druzd Sitek A" first="Agnieszka" last="Druzd-Sitek">Agnieszka Druzd-Sitek</name>
<affiliation wicri:level="1"><nlm:aff id="A11">Maria Sklodowska-Curie Institute – Oncology Center, Warsaw, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Maria Sklodowska-Curie Institute – Oncology Center, Warsaw</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Walewski, Jan" sort="Walewski, Jan" uniqKey="Walewski J" first="Jan" last="Walewski">Jan Walewski</name>
<affiliation wicri:level="1"><nlm:aff id="A11">Maria Sklodowska-Curie Institute – Oncology Center, Warsaw, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Maria Sklodowska-Curie Institute – Oncology Center, Warsaw</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Corso, Alessandro" sort="Corso, Alessandro" uniqKey="Corso A" first="Alessandro" last="Corso">Alessandro Corso</name>
<affiliation wicri:level="1"><nlm:aff id="A12">Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Cocito, Federica" sort="Cocito, Federica" uniqKey="Cocito F" first="Federica" last="Cocito">Federica Cocito</name>
<affiliation wicri:level="1"><nlm:aff id="A12">Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Vekemans, Marie Christine M" sort="Vekemans, Marie Christine M" uniqKey="Vekemans M" first="Marie-Christine M." last="Vekemans">Marie-Christine M. Vekemans</name>
<affiliation wicri:level="1"><nlm:aff id="A13">Cliniques Universitaires Saint-Luc, Brussels, Belgium</nlm:aff>
<country xml:lang="fr">Belgique</country>
<wicri:regionArea>Cliniques Universitaires Saint-Luc, Brussels</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Atilla, Erden" sort="Atilla, Erden" uniqKey="Atilla E" first="Erden" last="Atilla">Erden Atilla</name>
<affiliation wicri:level="1"><nlm:aff id="A14">Ankara University Medical School, Ankara, Turkey</nlm:aff>
<country xml:lang="fr">Turquie</country>
<wicri:regionArea>Ankara University Medical School, Ankara</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Beksac, Meral" sort="Beksac, Meral" uniqKey="Beksac M" first="Meral" last="Beksac">Meral Beksac</name>
<affiliation wicri:level="1"><nlm:aff id="A14">Ankara University Medical School, Ankara, Turkey</nlm:aff>
<country xml:lang="fr">Turquie</country>
<wicri:regionArea>Ankara University Medical School, Ankara</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Leleu, Xavier" sort="Leleu, Xavier" uniqKey="Leleu X" first="Xavier" last="Leleu">Xavier Leleu</name>
<affiliation wicri:level="1"><nlm:aff id="A15">Hospital Huriez, Lille, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Hospital Huriez, Lille</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Davila, Julio" sort="Davila, Julio" uniqKey="Davila J" first="Julio" last="Davila">Julio Davila</name>
<affiliation wicri:level="1"><nlm:aff id="A16">Hospital Universitario de Salamanca, Salamanca, Spain</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Hospital Universitario de Salamanca, Salamanca</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Badros, Ashraf" sort="Badros, Ashraf" uniqKey="Badros A" first="Ashraf" last="Badros">Ashraf Badros</name>
<affiliation wicri:level="1"><nlm:aff id="A17">University of Maryland Medical Center, Baltimore, Maryland, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>University of Maryland Medical Center, Baltimore, Maryland</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Aneja, Ekta" sort="Aneja, Ekta" uniqKey="Aneja E" first="Ekta" last="Aneja">Ekta Aneja</name>
<affiliation wicri:level="1"><nlm:aff id="A18">Weill Cornell Medical College, New York, New York, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Weill Cornell Medical College, New York, New York</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Abildgaard, Niels" sort="Abildgaard, Niels" uniqKey="Abildgaard N" first="Niels" last="Abildgaard">Niels Abildgaard</name>
<affiliation wicri:level="1"><nlm:aff id="A19">Odense University Hospital, Odense, Denmark</nlm:aff>
<country xml:lang="fr">Danemark</country>
<wicri:regionArea>Odense University Hospital, Odense</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Kastritis, Efstathios" sort="Kastritis, Efstathios" uniqKey="Kastritis E" first="Efstathios" last="Kastritis">Efstathios Kastritis</name>
<affiliation wicri:level="1"><nlm:aff id="A20">National and Kapodistrian University of Athens, Athens, Greece</nlm:aff>
<country xml:lang="fr">Grèce</country>
<wicri:regionArea>National and Kapodistrian University of Athens, Athens</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Fantl, Dorotea" sort="Fantl, Dorotea" uniqKey="Fantl D" first="Dorotea" last="Fantl">Dorotea Fantl</name>
<affiliation wicri:level="1"><nlm:aff id="A21">Hospital Italiano de Buenos Aires, Buenos Aires, Argentina</nlm:aff>
<country xml:lang="fr">Argentine</country>
<wicri:regionArea>Hospital Italiano de Buenos Aires, Buenos Aires</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Schutz, Natalia" sort="Schutz, Natalia" uniqKey="Schutz N" first="Natalia" last="Schutz">Natalia Schutz</name>
<affiliation wicri:level="1"><nlm:aff id="A21">Hospital Italiano de Buenos Aires, Buenos Aires, Argentina</nlm:aff>
<country xml:lang="fr">Argentine</country>
<wicri:regionArea>Hospital Italiano de Buenos Aires, Buenos Aires</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Pika, Tomas" sort="Pika, Tomas" uniqKey="Pika T" first="Tomas" last="Pika">Tomas Pika</name>
<affiliation wicri:level="1"><nlm:aff id="A22">University Hospital Olomouc, Olomouc, Czech Republic</nlm:aff>
<country xml:lang="fr">République tchèque</country>
<wicri:regionArea>University Hospital Olomouc, Olomouc</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Butrym, Aleksandra" sort="Butrym, Aleksandra" uniqKey="Butrym A" first="Aleksandra" last="Butrym">Aleksandra Butrym</name>
<affiliation wicri:level="1"><nlm:aff id="A23">Wroclaw Medical University, Wroclaw, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Wroclaw Medical University, Wroclaw</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Olszewska Szopa, Magdalena" sort="Olszewska Szopa, Magdalena" uniqKey="Olszewska Szopa M" first="Magdalena" last="Olszewska-Szopa">Magdalena Olszewska-Szopa</name>
<affiliation wicri:level="1"><nlm:aff id="A23">Wroclaw Medical University, Wroclaw, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Wroclaw Medical University, Wroclaw</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Usnarska Zubkiewicz, Lidia" sort="Usnarska Zubkiewicz, Lidia" uniqKey="Usnarska Zubkiewicz L" first="Lidia" last="Usnarska-Zubkiewicz">Lidia Usnarska-Zubkiewicz</name>
<affiliation wicri:level="1"><nlm:aff id="A23">Wroclaw Medical University, Wroclaw, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Wroclaw Medical University, Wroclaw</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Usmani, Saad" sort="Usmani, Saad" uniqKey="Usmani S" first="Saad" last="Usmani">Saad Usmani</name>
<affiliation wicri:level="1"><nlm:aff id="A24">Levine Cancer Institute/Carolinas HealthCare System, Charlotte, NC, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Levine Cancer Institute/Carolinas HealthCare System, Charlotte, NC</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Nahi, Hareth" sort="Nahi, Hareth" uniqKey="Nahi H" first="Hareth" last="Nahi">Hareth Nahi</name>
<affiliation wicri:level="1"><nlm:aff id="A25">Karolinska University Hospital, Stockholm, Sweden</nlm:aff>
<country xml:lang="fr">Suède</country>
<wicri:regionArea>Karolinska University Hospital, Stockholm</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Chim, Chor S" sort="Chim, Chor S" uniqKey="Chim C" first="Chor S" last="Chim">Chor S. Chim</name>
<affiliation wicri:level="1"><nlm:aff id="A26">Queen Mary Hospital, University of Hong Kong, Hong Kong</nlm:aff>
<country xml:lang="fr">Hong Kong</country>
<wicri:regionArea>Queen Mary Hospital, University of Hong Kong</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Shustik, Chaim" sort="Shustik, Chaim" uniqKey="Shustik C" first="Chaim" last="Shustik">Chaim Shustik</name>
<affiliation wicri:level="1"><nlm:aff id="A27">Royal Victoria Hospital, McGill University, Montreal, Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Royal Victoria Hospital, McGill University, Montreal</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Madry, Krzysztof" sort="Madry, Krzysztof" uniqKey="Madry K" first="Krzysztof" last="Madry">Krzysztof Madry</name>
<affiliation wicri:level="1"><nlm:aff id="A28">Medical University, Warsaw, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Medical University, Warsaw</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Lentzsch, Suzanne" sort="Lentzsch, Suzanne" uniqKey="Lentzsch S" first="Suzanne" last="Lentzsch">Suzanne Lentzsch</name>
<affiliation wicri:level="1"><nlm:aff id="A29">Columbia University Medical Center, New York, New York, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Columbia University Medical Center, New York, New York</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Swiderska, Alina" sort="Swiderska, Alina" uniqKey="Swiderska A" first="Alina" last="Swiderska">Alina Swiderska</name>
<affiliation wicri:level="1"><nlm:aff id="A30">Provincial Hospital, Zielona Gora, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Provincial Hospital, Zielona Gora</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Helbig, Grzegorz" sort="Helbig, Grzegorz" uniqKey="Helbig G" first="Grzegorz" last="Helbig">Grzegorz Helbig</name>
<affiliation wicri:level="1"><nlm:aff id="A31">Silesian Medical University, Katowice, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Silesian Medical University, Katowice</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Guzicka Kazimierczak, Renata" sort="Guzicka Kazimierczak, Renata" uniqKey="Guzicka Kazimierczak R" first="Renata" last="Guzicka-Kazimierczak">Renata Guzicka-Kazimierczak</name>
<affiliation wicri:level="1"><nlm:aff id="A32">Pomeranian Medical University, Szczecin, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Pomeranian Medical University, Szczecin</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Lendvai, Nikoletta" sort="Lendvai, Nikoletta" uniqKey="Lendvai N" first="Nikoletta" last="Lendvai">Nikoletta Lendvai</name>
<affiliation wicri:level="1"><nlm:aff id="A33">Memorial Sloan-Kettering Cancer Center, New York, New York, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Memorial Sloan-Kettering Cancer Center, New York, New York</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Waage, Anders" sort="Waage, Anders" uniqKey="Waage A" first="Anders" last="Waage">Anders Waage</name>
<affiliation wicri:level="1"><nlm:aff id="A34">Norwegian University of Science and Technology, Trondheim, Norway</nlm:aff>
<country xml:lang="fr">Norvège</country>
<wicri:regionArea>Norwegian University of Science and Technology, Trondheim</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Andersen, Kristian T" sort="Andersen, Kristian T" uniqKey="Andersen K" first="Kristian T." last="Andersen">Kristian T. Andersen</name>
<affiliation wicri:level="1"><nlm:aff id="A35">Vejle Hospital, Vejle, Denmark</nlm:aff>
<country xml:lang="fr">Danemark</country>
<wicri:regionArea>Vejle Hospital, Vejle</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Murakami, Hirokazu" sort="Murakami, Hirokazu" uniqKey="Murakami H" first="Hirokazu" last="Murakami">Hirokazu Murakami</name>
<affiliation wicri:level="1"><nlm:aff id="A36">Gunma University Graduate School of Health Sciences, Gunma, Japan</nlm:aff>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Gunma University Graduate School of Health Sciences, Gunma</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Zweegman, Sonja" sort="Zweegman, Sonja" uniqKey="Zweegman S" first="Sonja" last="Zweegman">Sonja Zweegman</name>
<affiliation wicri:level="1"><nlm:aff id="A37">VU University Medical Center, Amsterdam, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>VU University Medical Center, Amsterdam</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Castillo, Jorge J" sort="Castillo, Jorge J" uniqKey="Castillo J" first="Jorge J." last="Castillo">Jorge J. Castillo</name>
<affiliation wicri:level="1"><nlm:aff id="A38">Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts</wicri:regionArea>
</affiliation>
</author>
</analytic>
<series><title level="j">American journal of hematology</title>
<idno type="ISSN">0361-8609</idno>
<idno type="eISSN">1096-8652</idno>
<imprint><date when="2016">2016</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><p id="P1">The multicenter retrospective study conducted in 38 centers from 20 countries including 172 adult patients with CNS MM aimed to describe the clinical and pathological characteristics and outcomes of patients with multiple myeloma (MM) involving the central nervous system (CNS). Univariate and multivariate analyses were performed to identify prognostic factors for survival. The median time from MM diagnosis to CNS MM diagnosis was 3 years. Thirty-eight patients (22%) were diagnosed with CNS involvement at the time of initial MM diagnosis and 134 (78%) at relapse/progression. Upon diagnosis of CNS MM, 97% patients received initial therapy for CNS disease, of which 76% received systemic therapy, 36% radiotherapy and 32% intrathecal therapy. After a median follow-up of 3.5 years, the median overall survival (OS) from the onset of CNS involvement for the entire group was 7 months. Untreated and treated patients had median OS of 2 and 8 months, respectively (p<0.001). At least one previous line of therapy for MM before the diagnosis of CNS disease and >1 cytogenetic abnormality detected by FISH were independently associated with worse OS. The median OS for patients with 0, 1 and 2 of these risk factors were 25 months, 5.5 months and 2 months, respectively (p<0.001). Neurological manifestations, not considered chemotherapy-related, observed at any time after initial diagnosis of MM should raise a suspicion of CNS involvement. Although prognosis is generally poor, the survival of previously untreated patients and patients with favorable cytogenetic profile might be prolonged due to systemic treatment and/or radiotherapy.</p>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">7610369</journal-id>
<journal-id journal-id-type="pubmed-jr-id">422</journal-id>
<journal-id journal-id-type="nlm-ta">Am J Hematol</journal-id>
<journal-id journal-id-type="iso-abbrev">Am. J. Hematol.</journal-id>
<journal-title-group><journal-title>American journal of hematology</journal-title>
</journal-title-group>
<issn pub-type="ppub">0361-8609</issn>
<issn pub-type="epub">1096-8652</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">26955792</article-id>
<article-id pub-id-type="pmc">5502095</article-id>
<article-id pub-id-type="doi">10.1002/ajh.24351</article-id>
<article-id pub-id-type="manuscript">NIHMS864615</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Central Nervous System Involvement by Multiple Myeloma: a Multi-Institutional Retrospective Study of 172 Patients in daily clinical practice</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Jurczyszyn</surname>
<given-names>Artur</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Grzasko</surname>
<given-names>Norbert</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gozzetti</surname>
<given-names>Alessandro</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Czepiel</surname>
<given-names>Jacek</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Cerase</surname>
<given-names>Alfonso</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hungria</surname>
<given-names>Vania</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Crusoe</surname>
<given-names>Edvan</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Diaz</surname>
<given-names>Ana Luiza Miranda Silva</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Vij</surname>
<given-names>Ravi</given-names>
</name>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Fiala</surname>
<given-names>Mark A.</given-names>
</name>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Caers</surname>
<given-names>Jo</given-names>
</name>
<xref ref-type="aff" rid="A6">6</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Rasche</surname>
<given-names>Leo</given-names>
</name>
<xref ref-type="aff" rid="A7">7</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nooka</surname>
<given-names>Ajay K.</given-names>
</name>
<xref ref-type="aff" rid="A8">8</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lonial</surname>
<given-names>Sagar</given-names>
</name>
<xref ref-type="aff" rid="A8">8</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Vesole</surname>
<given-names>David H.</given-names>
</name>
<xref ref-type="aff" rid="A9">9</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Philip</surname>
<given-names>Sandhya</given-names>
</name>
<xref ref-type="aff" rid="A9">9</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gangatharan</surname>
<given-names>Shane</given-names>
</name>
<xref ref-type="aff" rid="A10">10</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Druzd-Sitek</surname>
<given-names>Agnieszka</given-names>
</name>
<xref ref-type="aff" rid="A11">11</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Walewski</surname>
<given-names>Jan</given-names>
</name>
<xref ref-type="aff" rid="A11">11</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Corso</surname>
<given-names>Alessandro</given-names>
</name>
<xref ref-type="aff" rid="A12">12</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Cocito</surname>
<given-names>Federica</given-names>
</name>
<xref ref-type="aff" rid="A12">12</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Vekemans</surname>
<given-names>Marie-Christine M.</given-names>
</name>
<xref ref-type="aff" rid="A13">13</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Atilla</surname>
<given-names>Erden</given-names>
</name>
<xref ref-type="aff" rid="A14">14</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Beksac</surname>
<given-names>Meral</given-names>
</name>
<xref ref-type="aff" rid="A14">14</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Leleu</surname>
<given-names>Xavier</given-names>
</name>
<xref ref-type="aff" rid="A15">15</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Davila</surname>
<given-names>Julio</given-names>
</name>
<xref ref-type="aff" rid="A16">16</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Badros</surname>
<given-names>Ashraf</given-names>
</name>
<xref ref-type="aff" rid="A17">17</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Aneja</surname>
<given-names>Ekta</given-names>
</name>
<xref ref-type="aff" rid="A18">18</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Abildgaard</surname>
<given-names>Niels</given-names>
</name>
<xref ref-type="aff" rid="A19">19</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kastritis</surname>
<given-names>Efstathios</given-names>
</name>
<xref ref-type="aff" rid="A20">20</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Fantl</surname>
<given-names>Dorotea</given-names>
</name>
<xref ref-type="aff" rid="A21">21</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Schutz</surname>
<given-names>Natalia</given-names>
</name>
<xref ref-type="aff" rid="A21">21</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Pika</surname>
<given-names>Tomas</given-names>
</name>
<xref ref-type="aff" rid="A22">22</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Butrym</surname>
<given-names>Aleksandra</given-names>
</name>
<xref ref-type="aff" rid="A23">23</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Olszewska-Szopa</surname>
<given-names>Magdalena</given-names>
</name>
<xref ref-type="aff" rid="A23">23</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Usnarska-Zubkiewicz</surname>
<given-names>Lidia</given-names>
</name>
<xref ref-type="aff" rid="A23">23</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Usmani</surname>
<given-names>Saad</given-names>
</name>
<xref ref-type="aff" rid="A24">24</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nahi</surname>
<given-names>Hareth</given-names>
</name>
<xref ref-type="aff" rid="A25">25</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Chim</surname>
<given-names>Chor S</given-names>
</name>
<xref ref-type="aff" rid="A26">26</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Shustik</surname>
<given-names>Chaim</given-names>
</name>
<xref ref-type="aff" rid="A27">27</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Madry</surname>
<given-names>Krzysztof</given-names>
</name>
<xref ref-type="aff" rid="A28">28</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lentzsch</surname>
<given-names>Suzanne</given-names>
</name>
<xref ref-type="aff" rid="A29">29</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Swiderska</surname>
<given-names>Alina</given-names>
</name>
<xref ref-type="aff" rid="A30">30</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Helbig</surname>
<given-names>Grzegorz</given-names>
</name>
<xref ref-type="aff" rid="A31">31</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Guzicka-Kazimierczak</surname>
<given-names>Renata</given-names>
</name>
<xref ref-type="aff" rid="A32">32</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lendvai</surname>
<given-names>Nikoletta</given-names>
</name>
<xref ref-type="aff" rid="A33">33</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Waage</surname>
<given-names>Anders</given-names>
</name>
<xref ref-type="aff" rid="A34">34</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Andersen</surname>
<given-names>Kristian T.</given-names>
</name>
<xref ref-type="aff" rid="A35">35</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Murakami</surname>
<given-names>Hirokazu</given-names>
</name>
<xref ref-type="aff" rid="A36">36</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Zweegman</surname>
<given-names>Sonja</given-names>
</name>
<xref ref-type="aff" rid="A37">37</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Castillo</surname>
<given-names>Jorge J.</given-names>
</name>
<xref ref-type="aff" rid="A38">38</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Jagiellonian University Medical College, Cracow, Poland</aff>
<aff id="A2"><label>2</label>
Medical University of Lublin, Department of Hematooncology and Bone Marrow Transplantation, Lublin, Poland; St. John’s Cancer Center, Department of Hematology, Lublin, Poland</aff>
<aff id="A3"><label>3</label>
Azienda Ospedaliera Universitaria Senese, Siena, Italy</aff>
<aff id="A4"><label>4</label>
Santa Casa Medical School, Sao Paulo, Brazil</aff>
<aff id="A5"><label>5</label>
Washington University School of Medicine, St. Louis, Missouri, USA</aff>
<aff id="A6"><label>6</label>
Centre Hospitalier Universitaire de Liege, Liege, Belgium</aff>
<aff id="A7"><label>7</label>
University Hospital Wuerzburg, Wuerzburg, Germany</aff>
<aff id="A8"><label>8</label>
Winship Cancer Institute, Emory University, Atlanta, Georgia, USA</aff>
<aff id="A9"><label>9</label>
John Theurer Cancer Center at Hackensack UMC, New Jersey, USA</aff>
<aff id="A10"><label>10</label>
Fremantle Hospital, Fremantle, Australia</aff>
<aff id="A11"><label>11</label>
Maria Sklodowska-Curie Institute – Oncology Center, Warsaw, Poland</aff>
<aff id="A12"><label>12</label>
Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy</aff>
<aff id="A13"><label>13</label>
Cliniques Universitaires Saint-Luc, Brussels, Belgium</aff>
<aff id="A14"><label>14</label>
Ankara University Medical School, Ankara, Turkey</aff>
<aff id="A15"><label>15</label>
Hospital Huriez, Lille, France</aff>
<aff id="A16"><label>16</label>
Hospital Universitario de Salamanca, Salamanca, Spain</aff>
<aff id="A17"><label>17</label>
University of Maryland Medical Center, Baltimore, Maryland, USA</aff>
<aff id="A18"><label>18</label>
Weill Cornell Medical College, New York, New York, USA</aff>
<aff id="A19"><label>19</label>
Odense University Hospital, Odense, Denmark</aff>
<aff id="A20"><label>20</label>
National and Kapodistrian University of Athens, Athens, Greece</aff>
<aff id="A21"><label>21</label>
Hospital Italiano de Buenos Aires, Buenos Aires, Argentina</aff>
<aff id="A22"><label>22</label>
University Hospital Olomouc, Olomouc, Czech Republic</aff>
<aff id="A23"><label>23</label>
Wroclaw Medical University, Wroclaw, Poland</aff>
<aff id="A24"><label>24</label>
Levine Cancer Institute/Carolinas HealthCare System, Charlotte, NC, USA</aff>
<aff id="A25"><label>25</label>
Karolinska University Hospital, Stockholm, Sweden</aff>
<aff id="A26"><label>26</label>
Queen Mary Hospital, University of Hong Kong, Hong Kong</aff>
<aff id="A27"><label>27</label>
Royal Victoria Hospital, McGill University, Montreal, Canada</aff>
<aff id="A28"><label>28</label>
Medical University, Warsaw, Poland</aff>
<aff id="A29"><label>29</label>
Columbia University Medical Center, New York, New York, USA</aff>
<aff id="A30"><label>30</label>
Provincial Hospital, Zielona Gora, Poland</aff>
<aff id="A31"><label>31</label>
Silesian Medical University, Katowice, Poland</aff>
<aff id="A32"><label>32</label>
Pomeranian Medical University, Szczecin, Poland</aff>
<aff id="A33"><label>33</label>
Memorial Sloan-Kettering Cancer Center, New York, New York, USA</aff>
<aff id="A34"><label>34</label>
Norwegian University of Science and Technology, Trondheim, Norway</aff>
<aff id="A35"><label>35</label>
Vejle Hospital, Vejle, Denmark</aff>
<aff id="A36"><label>36</label>
Gunma University Graduate School of Health Sciences, Gunma, Japan</aff>
<aff id="A37"><label>37</label>
VU University Medical Center, Amsterdam, The Netherlands</aff>
<aff id="A38"><label>38</label>
Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA</aff>
<author-notes><corresp id="FN1">Corresponding author: Artur Jurczyszyn, MD, PhD, Department of Hematology Jagiellonian University Medical College, 17 Kopernika Str., 31-501 Krakow, Poland; phone +48124247600, fax +48124247426, <email>mmjurczy@cyf-kr.edu.pl</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>20</day>
<month>4</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub"><day>24</day>
<month>4</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="ppub"><month>6</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>09</day>
<month>7</month>
<year>2017</year>
</pub-date>
<volume>91</volume>
<issue>6</issue>
<fpage>575</fpage>
<lpage>580</lpage>
<pmc-comment>elocation-id from pubmed: 10.1002/ajh.24351</pmc-comment>
<abstract><p id="P1">The multicenter retrospective study conducted in 38 centers from 20 countries including 172 adult patients with CNS MM aimed to describe the clinical and pathological characteristics and outcomes of patients with multiple myeloma (MM) involving the central nervous system (CNS). Univariate and multivariate analyses were performed to identify prognostic factors for survival. The median time from MM diagnosis to CNS MM diagnosis was 3 years. Thirty-eight patients (22%) were diagnosed with CNS involvement at the time of initial MM diagnosis and 134 (78%) at relapse/progression. Upon diagnosis of CNS MM, 97% patients received initial therapy for CNS disease, of which 76% received systemic therapy, 36% radiotherapy and 32% intrathecal therapy. After a median follow-up of 3.5 years, the median overall survival (OS) from the onset of CNS involvement for the entire group was 7 months. Untreated and treated patients had median OS of 2 and 8 months, respectively (p<0.001). At least one previous line of therapy for MM before the diagnosis of CNS disease and >1 cytogenetic abnormality detected by FISH were independently associated with worse OS. The median OS for patients with 0, 1 and 2 of these risk factors were 25 months, 5.5 months and 2 months, respectively (p<0.001). Neurological manifestations, not considered chemotherapy-related, observed at any time after initial diagnosis of MM should raise a suspicion of CNS involvement. Although prognosis is generally poor, the survival of previously untreated patients and patients with favorable cytogenetic profile might be prolonged due to systemic treatment and/or radiotherapy.</p>
</abstract>
<kwd-group><kwd>multiple myeloma</kwd>
<kwd>therapy</kwd>
<kwd>central nervous system</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Asie/explor/AustralieFrV1/Data/Pmc/Curation
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 001E18 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Curation/biblio.hfd -nk 001E18 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien |wiki= Wicri/Asie |area= AustralieFrV1 |flux= Pmc |étape= Curation |type= RBID |clé= PMC:5502095 |texte= Central Nervous System Involvement by Multiple Myeloma: a Multi-Institutional Retrospective Study of 172 Patients in daily clinical practice }}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Curation/RBID.i -Sk "pubmed:26955792" \ | HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Curation/biblio.hfd \ | NlmPubMed2Wicri -a AustralieFrV1
![]() | This area was generated with Dilib version V0.6.33. | ![]() |