AustralieFrV1, PubMed, Corpus, bibRecord, 001E18

Central nervous system involvement by multiple myeloma: A multi-institutional retrospective study of 172 patients in daily clinical practice.

Identifieur interne : 001E18 ( PubMed/Corpus ); précédent : 001E17; suivant : 001E19

Central nervous system involvement by multiple myeloma: A multi-institutional retrospective study of 172 patients in daily clinical practice.

Auteurs : Artur Jurczyszyn ; Norbert Grzasko ; Alessandro Gozzetti ; Jacek Czepiel ; Alfonso Cerase ; Vania Hungria ; Edvan Crusoe ; Ana Luiza Miranda Silva Dias ; Ravi Vij ; Mark A. Fiala ; Jo Caers ; Leo Rasche ; Ajay K. Nooka ; Sagar Lonial ; David H. Vesole ; Sandhya Philip ; Shane Gangatharan ; Agnieszka Druzd-Sitek ; Jan Walewski ; Alessandro Corso ; Federica Cocito ; Marie-Christine M. Vekemans ; Erden Atilla ; Meral Beksac ; Xavier Leleu ; Julio Davila ; Ashraf Badros ; Ekta Aneja ; Niels Abildgaard ; Efstathios Kastritis ; Dorotea Fantl ; Natalia Schutz ; Tomas Pika ; Aleksandra Butrym ; Magdalena Olszewska-Szopa ; Lidia Usnarska-Zubkiewicz ; Saad Z. Usmani ; Hareth Nahi ; Chor S. Chim ; Chaim Shustik ; Krzysztof Madry ; Suzanne Lentzsch ; Alina Swiderska ; Grzegorz Helbig ; Renata Guzicka-Kazimierczak ; Nikoletta Lendvai ; Anders Waage ; Kristian T. Andersen ; Hirokazu Murakami ; Sonja Zweegman ; Jorge J. Castillo

Source :

American journal of hematology [ 1096-8652 ] ; 2016.

RBID : pubmed:26955792

English descriptors

KwdEn :
- Adult, Aged, Aged, 80 and over, Antineoplastic Agents (therapeutic use), Central Nervous System Neoplasms (diagnosis), Central Nervous System Neoplasms (mortality), Central Nervous System Neoplasms (secondary), Central Nervous System Neoplasms (therapy), Chromosome Aberrations, Combined Modality Therapy, Female, Humans, Male, Middle Aged, Multiple Myeloma (complications), Multiple Myeloma (mortality), Multiple Myeloma (pathology), Multiple Myeloma (therapy), Prognosis, Radiotherapy, Retrospective Studies, Survival Analysis, Survival Rate, Treatment Outcome.
MESH :
- chemical , therapeutic use : Antineoplastic Agents.
- complications : Multiple Myeloma.
- diagnosis : Central Nervous System Neoplasms.
- mortality : Central Nervous System Neoplasms, Multiple Myeloma.
- pathology : Multiple Myeloma.
- secondary : Central Nervous System Neoplasms.
- therapy : Central Nervous System Neoplasms, Multiple Myeloma.
- Adult, Aged, Aged, 80 and over, Chromosome Aberrations, Combined Modality Therapy, Female, Humans, Male, Middle Aged, Prognosis, Radiotherapy, Retrospective Studies, Survival Analysis, Survival Rate, Treatment Outcome.

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. Am. J. Hematol. 91:575-580, 2016. © 2016 Wiley Periodicals, Inc.

DOI: 10.1002/ajh.24351
PubMed: 26955792

Links to Exploration step

pubmed:26955792

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<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><nlm:affiliation>Jagiellonian University Medical College, Cracow, Poland.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Grzasko, Norbert" sort="Grzasko, Norbert" uniqKey="Grzasko N" first="Norbert" last="Grzasko">Norbert Grzasko</name>
<affiliation><nlm:affiliation>Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Gozzetti, Alessandro" sort="Gozzetti, Alessandro" uniqKey="Gozzetti A" first="Alessandro" last="Gozzetti">Alessandro Gozzetti</name>
<affiliation><nlm:affiliation>Azienda Ospedaliera Universitaria Senese, Siena, Italy.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Czepiel, Jacek" sort="Czepiel, Jacek" uniqKey="Czepiel J" first="Jacek" last="Czepiel">Jacek Czepiel</name>
<affiliation><nlm:affiliation>Jagiellonian University Medical College, Cracow, Poland.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Cerase, Alfonso" sort="Cerase, Alfonso" uniqKey="Cerase A" first="Alfonso" last="Cerase">Alfonso Cerase</name>
<affiliation><nlm:affiliation>Azienda Ospedaliera Universitaria Senese, Siena, Italy.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Hungria, Vania" sort="Hungria, Vania" uniqKey="Hungria V" first="Vania" last="Hungria">Vania Hungria</name>
<affiliation><nlm:affiliation>Santa Casa Medical School, Sao Paulo, Brazil.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Crusoe, Edvan" sort="Crusoe, Edvan" uniqKey="Crusoe E" first="Edvan" last="Crusoe">Edvan Crusoe</name>
<affiliation><nlm:affiliation>Santa Casa Medical School, Sao Paulo, Brazil.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Silva Dias, Ana Luiza Miranda" sort="Silva Dias, Ana Luiza Miranda" uniqKey="Silva Dias A" first="Ana Luiza Miranda" last="Silva Dias">Ana Luiza Miranda Silva Dias</name>
<affiliation><nlm:affiliation>Santa Casa Medical School, Sao Paulo, Brazil.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Vij, Ravi" sort="Vij, Ravi" uniqKey="Vij R" first="Ravi" last="Vij">Ravi Vij</name>
<affiliation><nlm:affiliation>Washington University School of Medicine, St. Louis, Missouri.</nlm:affiliation>
</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><nlm:affiliation>Washington University School of Medicine, St. Louis, Missouri.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Caers, Jo" sort="Caers, Jo" uniqKey="Caers J" first="Jo" last="Caers">Jo Caers</name>
<affiliation><nlm:affiliation>Centre Hospitalier Universitaire de Liege, Liege, Belgium.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Rasche, Leo" sort="Rasche, Leo" uniqKey="Rasche L" first="Leo" last="Rasche">Leo Rasche</name>
<affiliation><nlm:affiliation>University Hospital Wuerzburg, Wuerzburg, Germany.</nlm:affiliation>
</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><nlm:affiliation>Winship Cancer Institute, Emory University, Atlanta, Georgia.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Lonial, Sagar" sort="Lonial, Sagar" uniqKey="Lonial S" first="Sagar" last="Lonial">Sagar Lonial</name>
<affiliation><nlm:affiliation>Winship Cancer Institute, Emory University, Atlanta, Georgia.</nlm:affiliation>
</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><nlm:affiliation>John Theurer Cancer Center at Hackensack UMC, New Jersey and Georgetown University, Washington, DC.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Philip, Sandhya" sort="Philip, Sandhya" uniqKey="Philip S" first="Sandhya" last="Philip">Sandhya Philip</name>
<affiliation><nlm:affiliation>John Theurer Cancer Center at Hackensack UMC, New Jersey and Georgetown University, Washington, DC.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Gangatharan, Shane" sort="Gangatharan, Shane" uniqKey="Gangatharan S" first="Shane" last="Gangatharan">Shane Gangatharan</name>
<affiliation><nlm:affiliation>Fremantle Hospital, Fremantle, Australia.</nlm:affiliation>
</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><nlm:affiliation>Maria Sklodowska-Curie Institute - Oncology Center, Warsaw, Poland.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Walewski, Jan" sort="Walewski, Jan" uniqKey="Walewski J" first="Jan" last="Walewski">Jan Walewski</name>
<affiliation><nlm:affiliation>Maria Sklodowska-Curie Institute - Oncology Center, Warsaw, Poland.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Corso, Alessandro" sort="Corso, Alessandro" uniqKey="Corso A" first="Alessandro" last="Corso">Alessandro Corso</name>
<affiliation><nlm:affiliation>Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Cocito, Federica" sort="Cocito, Federica" uniqKey="Cocito F" first="Federica" last="Cocito">Federica Cocito</name>
<affiliation><nlm:affiliation>Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.</nlm:affiliation>
</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><nlm:affiliation>Cliniques Universitaires Saint-Luc, Brussels, Belgium.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Atilla, Erden" sort="Atilla, Erden" uniqKey="Atilla E" first="Erden" last="Atilla">Erden Atilla</name>
<affiliation><nlm:affiliation>Ankara University Medical School, Ankara, Turkey.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Beksac, Meral" sort="Beksac, Meral" uniqKey="Beksac M" first="Meral" last="Beksac">Meral Beksac</name>
<affiliation><nlm:affiliation>Ankara University Medical School, Ankara, Turkey.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Leleu, Xavier" sort="Leleu, Xavier" uniqKey="Leleu X" first="Xavier" last="Leleu">Xavier Leleu</name>
<affiliation><nlm:affiliation>Hopital La Miletrie, CHU Poitiers, France.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Davila, Julio" sort="Davila, Julio" uniqKey="Davila J" first="Julio" last="Davila">Julio Davila</name>
<affiliation><nlm:affiliation>Hospital Universitario de Salamanca, Salamanca, Spain.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Badros, Ashraf" sort="Badros, Ashraf" uniqKey="Badros A" first="Ashraf" last="Badros">Ashraf Badros</name>
<affiliation><nlm:affiliation>University of Maryland Medical Center, Baltimore, Maryland.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Aneja, Ekta" sort="Aneja, Ekta" uniqKey="Aneja E" first="Ekta" last="Aneja">Ekta Aneja</name>
<affiliation><nlm:affiliation>Weill Cornell Medical College, New York, New York.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Abildgaard, Niels" sort="Abildgaard, Niels" uniqKey="Abildgaard N" first="Niels" last="Abildgaard">Niels Abildgaard</name>
<affiliation><nlm:affiliation>Odense University Hospital, Odense, Denmark.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Kastritis, Efstathios" sort="Kastritis, Efstathios" uniqKey="Kastritis E" first="Efstathios" last="Kastritis">Efstathios Kastritis</name>
<affiliation><nlm:affiliation>National and Kapodistrian University of Athens, Athens, Greece.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Fantl, Dorotea" sort="Fantl, Dorotea" uniqKey="Fantl D" first="Dorotea" last="Fantl">Dorotea Fantl</name>
<affiliation><nlm:affiliation>Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Schutz, Natalia" sort="Schutz, Natalia" uniqKey="Schutz N" first="Natalia" last="Schutz">Natalia Schutz</name>
<affiliation><nlm:affiliation>Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Pika, Tomas" sort="Pika, Tomas" uniqKey="Pika T" first="Tomas" last="Pika">Tomas Pika</name>
<affiliation><nlm:affiliation>University Hospital Olomouc, Olomouc, Czech Republic.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Butrym, Aleksandra" sort="Butrym, Aleksandra" uniqKey="Butrym A" first="Aleksandra" last="Butrym">Aleksandra Butrym</name>
<affiliation><nlm:affiliation>Wroclaw Medical University, Wroclaw, Poland.</nlm:affiliation>
</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><nlm:affiliation>Wroclaw Medical University, Wroclaw, Poland.</nlm:affiliation>
</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><nlm:affiliation>Wroclaw Medical University, Wroclaw, Poland.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Usmani, Saad Z" sort="Usmani, Saad Z" uniqKey="Usmani S" first="Saad Z" last="Usmani">Saad Z. Usmani</name>
<affiliation><nlm:affiliation>Levine Cancer Institute/Carolinas HealthCare System, Charlotte, NC.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Nahi, Hareth" sort="Nahi, Hareth" uniqKey="Nahi H" first="Hareth" last="Nahi">Hareth Nahi</name>
<affiliation><nlm:affiliation>Karolinska University Hospital, Stockholm, Sweden.</nlm:affiliation>
</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><nlm:affiliation>Queen Mary Hospital, University of Hong Kong, Hong Kong.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Shustik, Chaim" sort="Shustik, Chaim" uniqKey="Shustik C" first="Chaim" last="Shustik">Chaim Shustik</name>
<affiliation><nlm:affiliation>Royal Victoria Hospital, McGill University, Montreal, Canada.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Madry, Krzysztof" sort="Madry, Krzysztof" uniqKey="Madry K" first="Krzysztof" last="Madry">Krzysztof Madry</name>
<affiliation><nlm:affiliation>Medical University, Warsaw, Poland.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Lentzsch, Suzanne" sort="Lentzsch, Suzanne" uniqKey="Lentzsch S" first="Suzanne" last="Lentzsch">Suzanne Lentzsch</name>
<affiliation><nlm:affiliation>Columbia University Medical Center, New York, New York.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Swiderska, Alina" sort="Swiderska, Alina" uniqKey="Swiderska A" first="Alina" last="Swiderska">Alina Swiderska</name>
<affiliation><nlm:affiliation>Provincial Hospital, Zielona Gora, Poland.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Helbig, Grzegorz" sort="Helbig, Grzegorz" uniqKey="Helbig G" first="Grzegorz" last="Helbig">Grzegorz Helbig</name>
<affiliation><nlm:affiliation>Silesian Medical University, Katowice, Poland.</nlm:affiliation>
</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><nlm:affiliation>Pomeranian Medical University, Szczecin, Poland.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Lendvai, Nikoletta" sort="Lendvai, Nikoletta" uniqKey="Lendvai N" first="Nikoletta" last="Lendvai">Nikoletta Lendvai</name>
<affiliation><nlm:affiliation>Memorial Sloan-Kettering Cancer Center, New York, New York.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Waage, Anders" sort="Waage, Anders" uniqKey="Waage A" first="Anders" last="Waage">Anders Waage</name>
<affiliation><nlm:affiliation>Norwegian University of Science and Technology, Trondheim, Norway.</nlm:affiliation>
</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><nlm:affiliation>Vejle Hospital, Vejle, Denmark.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Murakami, Hirokazu" sort="Murakami, Hirokazu" uniqKey="Murakami H" first="Hirokazu" last="Murakami">Hirokazu Murakami</name>
<affiliation><nlm:affiliation>Gunma University Graduate School of Health Sciences, Gunma, Japan.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Zweegman, Sonja" sort="Zweegman, Sonja" uniqKey="Zweegman S" first="Sonja" last="Zweegman">Sonja Zweegman</name>
<affiliation><nlm:affiliation>VU University Medical Center, Amsterdam, the Netherlands.</nlm:affiliation>
</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><nlm:affiliation>Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.</nlm:affiliation>
</affiliation>
</author>
</titleStmt>
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<idno type="doi">10.1002/ajh.24351</idno>
<idno type="wicri:Area/PubMed/Corpus">001E18</idno>
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<sourceDesc><biblStruct><analytic><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><nlm:affiliation>Jagiellonian University Medical College, Cracow, Poland.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Grzasko, Norbert" sort="Grzasko, Norbert" uniqKey="Grzasko N" first="Norbert" last="Grzasko">Norbert Grzasko</name>
<affiliation><nlm:affiliation>Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Gozzetti, Alessandro" sort="Gozzetti, Alessandro" uniqKey="Gozzetti A" first="Alessandro" last="Gozzetti">Alessandro Gozzetti</name>
<affiliation><nlm:affiliation>Azienda Ospedaliera Universitaria Senese, Siena, Italy.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Czepiel, Jacek" sort="Czepiel, Jacek" uniqKey="Czepiel J" first="Jacek" last="Czepiel">Jacek Czepiel</name>
<affiliation><nlm:affiliation>Jagiellonian University Medical College, Cracow, Poland.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Cerase, Alfonso" sort="Cerase, Alfonso" uniqKey="Cerase A" first="Alfonso" last="Cerase">Alfonso Cerase</name>
<affiliation><nlm:affiliation>Azienda Ospedaliera Universitaria Senese, Siena, Italy.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Hungria, Vania" sort="Hungria, Vania" uniqKey="Hungria V" first="Vania" last="Hungria">Vania Hungria</name>
<affiliation><nlm:affiliation>Santa Casa Medical School, Sao Paulo, Brazil.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Crusoe, Edvan" sort="Crusoe, Edvan" uniqKey="Crusoe E" first="Edvan" last="Crusoe">Edvan Crusoe</name>
<affiliation><nlm:affiliation>Santa Casa Medical School, Sao Paulo, Brazil.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Silva Dias, Ana Luiza Miranda" sort="Silva Dias, Ana Luiza Miranda" uniqKey="Silva Dias A" first="Ana Luiza Miranda" last="Silva Dias">Ana Luiza Miranda Silva Dias</name>
<affiliation><nlm:affiliation>Santa Casa Medical School, Sao Paulo, Brazil.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Vij, Ravi" sort="Vij, Ravi" uniqKey="Vij R" first="Ravi" last="Vij">Ravi Vij</name>
<affiliation><nlm:affiliation>Washington University School of Medicine, St. Louis, Missouri.</nlm:affiliation>
</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><nlm:affiliation>Washington University School of Medicine, St. Louis, Missouri.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Caers, Jo" sort="Caers, Jo" uniqKey="Caers J" first="Jo" last="Caers">Jo Caers</name>
<affiliation><nlm:affiliation>Centre Hospitalier Universitaire de Liege, Liege, Belgium.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Rasche, Leo" sort="Rasche, Leo" uniqKey="Rasche L" first="Leo" last="Rasche">Leo Rasche</name>
<affiliation><nlm:affiliation>University Hospital Wuerzburg, Wuerzburg, Germany.</nlm:affiliation>
</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><nlm:affiliation>Winship Cancer Institute, Emory University, Atlanta, Georgia.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Lonial, Sagar" sort="Lonial, Sagar" uniqKey="Lonial S" first="Sagar" last="Lonial">Sagar Lonial</name>
<affiliation><nlm:affiliation>Winship Cancer Institute, Emory University, Atlanta, Georgia.</nlm:affiliation>
</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><nlm:affiliation>John Theurer Cancer Center at Hackensack UMC, New Jersey and Georgetown University, Washington, DC.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Philip, Sandhya" sort="Philip, Sandhya" uniqKey="Philip S" first="Sandhya" last="Philip">Sandhya Philip</name>
<affiliation><nlm:affiliation>John Theurer Cancer Center at Hackensack UMC, New Jersey and Georgetown University, Washington, DC.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Gangatharan, Shane" sort="Gangatharan, Shane" uniqKey="Gangatharan S" first="Shane" last="Gangatharan">Shane Gangatharan</name>
<affiliation><nlm:affiliation>Fremantle Hospital, Fremantle, Australia.</nlm:affiliation>
</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><nlm:affiliation>Maria Sklodowska-Curie Institute - Oncology Center, Warsaw, Poland.</nlm:affiliation>
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</author>
<author><name sortKey="Walewski, Jan" sort="Walewski, Jan" uniqKey="Walewski J" first="Jan" last="Walewski">Jan Walewski</name>
<affiliation><nlm:affiliation>Maria Sklodowska-Curie Institute - Oncology Center, Warsaw, Poland.</nlm:affiliation>
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</author>
<author><name sortKey="Corso, Alessandro" sort="Corso, Alessandro" uniqKey="Corso A" first="Alessandro" last="Corso">Alessandro Corso</name>
<affiliation><nlm:affiliation>Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.</nlm:affiliation>
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</author>
<author><name sortKey="Cocito, Federica" sort="Cocito, Federica" uniqKey="Cocito F" first="Federica" last="Cocito">Federica Cocito</name>
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</author>
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<affiliation><nlm:affiliation>Ankara University Medical School, Ankara, Turkey.</nlm:affiliation>
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<author><name sortKey="Beksac, Meral" sort="Beksac, Meral" uniqKey="Beksac M" first="Meral" last="Beksac">Meral Beksac</name>
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</author>
<author><name sortKey="Leleu, Xavier" sort="Leleu, Xavier" uniqKey="Leleu X" first="Xavier" last="Leleu">Xavier Leleu</name>
<affiliation><nlm:affiliation>Hopital La Miletrie, CHU Poitiers, France.</nlm:affiliation>
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</author>
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<affiliation><nlm:affiliation>Hospital Universitario de Salamanca, Salamanca, Spain.</nlm:affiliation>
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</author>
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<affiliation><nlm:affiliation>University of Maryland Medical Center, Baltimore, Maryland.</nlm:affiliation>
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<author><name sortKey="Aneja, Ekta" sort="Aneja, Ekta" uniqKey="Aneja E" first="Ekta" last="Aneja">Ekta Aneja</name>
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<affiliation><nlm:affiliation>Odense University Hospital, Odense, Denmark.</nlm:affiliation>
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<affiliation><nlm:affiliation>National and Kapodistrian University of Athens, Athens, Greece.</nlm:affiliation>
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<affiliation><nlm:affiliation>Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.</nlm:affiliation>
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<author><name sortKey="Schutz, Natalia" sort="Schutz, Natalia" uniqKey="Schutz N" first="Natalia" last="Schutz">Natalia Schutz</name>
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<author><name sortKey="Pika, Tomas" sort="Pika, Tomas" uniqKey="Pika T" first="Tomas" last="Pika">Tomas Pika</name>
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<affiliation><nlm:affiliation>Wroclaw Medical University, Wroclaw, Poland.</nlm:affiliation>
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<affiliation><nlm:affiliation>Wroclaw Medical University, Wroclaw, Poland.</nlm:affiliation>
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<author><name sortKey="Usnarska Zubkiewicz, Lidia" sort="Usnarska Zubkiewicz, Lidia" uniqKey="Usnarska Zubkiewicz L" first="Lidia" last="Usnarska-Zubkiewicz">Lidia Usnarska-Zubkiewicz</name>
<affiliation><nlm:affiliation>Wroclaw Medical University, Wroclaw, Poland.</nlm:affiliation>
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<author><name sortKey="Usmani, Saad Z" sort="Usmani, Saad Z" uniqKey="Usmani S" first="Saad Z" last="Usmani">Saad Z. Usmani</name>
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<series><title level="j">American journal of hematology</title>
<idno type="eISSN">1096-8652</idno>
<imprint><date when="2016" type="published">2016</date>
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<term>Central Nervous System Neoplasms (diagnosis)</term>
<term>Central Nervous System Neoplasms (mortality)</term>
<term>Central Nervous System Neoplasms (secondary)</term>
<term>Central Nervous System Neoplasms (therapy)</term>
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<term>Combined Modality Therapy</term>
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<term>Humans</term>
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<term>Middle Aged</term>
<term>Multiple Myeloma (complications)</term>
<term>Multiple Myeloma (mortality)</term>
<term>Multiple Myeloma (pathology)</term>
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<term>Radiotherapy</term>
<term>Retrospective Studies</term>
<term>Survival Analysis</term>
<term>Survival Rate</term>
<term>Treatment Outcome</term>
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<front><div type="abstract" xml:lang="en">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. Am. J. Hematol. 91:575-580, 2016. © 2016 Wiley Periodicals, Inc.</div>
</front>
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<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">26955792</PMID>
<DateCreated><Year>2016</Year>
<Month>05</Month>
<Day>17</Day>
</DateCreated>
<DateCompleted><Year>2017</Year>
<Month>06</Month>
<Day>23</Day>
</DateCompleted>
<DateRevised><Year>2017</Year>
<Month>07</Month>
<Day>14</Day>
</DateRevised>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1096-8652</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>91</Volume>
<Issue>6</Issue>
<PubDate><Year>2016</Year>
<Month>Jun</Month>
</PubDate>
</JournalIssue>
<Title>American journal of hematology</Title>
<ISOAbbreviation>Am. J. Hematol.</ISOAbbreviation>
</Journal>
<ArticleTitle>Central nervous system involvement by multiple myeloma: A multi-institutional retrospective study of 172 patients in daily clinical practice.</ArticleTitle>
<Pagination><MedlinePgn>575-80</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1002/ajh.24351</ELocationID>
<Abstract><AbstractText>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. Am. J. Hematol. 91:575-580, 2016. © 2016 Wiley Periodicals, Inc.</AbstractText>
<CopyrightInformation>© 2016 Wiley Periodicals, Inc.</CopyrightInformation>
</Abstract>
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<AffiliationInfo><Affiliation>Jagiellonian University Medical College, Cracow, Poland.</Affiliation>
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<Initials>MA</Initials>
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<AffiliationInfo><Affiliation>Centre Hospitalier Universitaire de Liege, Liege, Belgium.</Affiliation>
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<ForeName>Leo</ForeName>
<Initials>L</Initials>
<AffiliationInfo><Affiliation>University Hospital Wuerzburg, Wuerzburg, Germany.</Affiliation>
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<AffiliationInfo><Affiliation>Winship Cancer Institute, Emory University, Atlanta, Georgia.</Affiliation>
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Central nervous system involvement by multiple myeloma: A multi-institutional retrospective study of 172 patients in daily clinical practice.

Central nervous system involvement by multiple myeloma: A multi-institutional retrospective study of 172 patients in daily clinical practice.

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