Title: Clinical features of multiple myeloma patients with isolated extramedullary relapse

Authors: Xiaoyan Qu*  Lijuan Chen  Tian Tian  Limin Duan  Ruinan Lu  Hua Lu  Hanxin Wu Jianyong Li 

Institution: Department of Hematology, First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu Province, 210029, China

Abstract: Objective To analyze the clinical features and prognosis of multiple myeloma (MM) with isolated extramedullary relapse and in the absence of systemic progression. Methods The clinical features and outcome were retrospectively analyzed in six MM patients. Results These patients were secretory multiple myeloma at diagnosis. When relapsed, the dissociation between medullary and extramedullary response was detected. The serum or urine monoclonal component was extremely low or absent. The plasma cells in bone marrow were <5%. All patients received new targeted therapies (thalidomide or bortezomib) before extramedullary relapse. It is difficult to achieve second remission for them. Even in those having response, the duration of response was extremely short. The median overall survival from diagnosis and from extramedullary relapse was 19 months and 6 months, respectively. The overall survival was significantly shorter compared to the patients without extramedullary involvement (84 months, p=0.001). Conclusions These patients represent a special and rare relapse pattern. Patients with this relapse pattern were resistant to current therapies including novel targeted agents and associated with poor prognosis.

Keywords: Multiple myeloma, Extramedullary, Clinical feature, Prognosis

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J Biomed Res published on June 15th, 2013, doi:10.7555/JBR.29. 20140090