Clinical characteristics and prognostic analysis of multiple myeloma involving central nervous system

doi:10.3969/j.issn.1006-7795.2023.01.024

Abstract

Abstract: Objective To investigate the clinicopathological features and prognostic survival of multiple myeloma (MM) with central nervous system (CNS) involvement. Methods Among 1 529 MM patients reviewed, totally 18 MM patients with CNS involvement were included in this retrospective study. Both clinical and prognostic characteristics of MM and the involved intracranial site were analyzed. Results CNS involvement occurred in 1.2% of MM patients. The average age was (54.5±11.0) years. The fluorescence in situ hybridization (FISH)detection suggested that 43.8% of patients with CNS MM had high-risk cytogenetic abnormality with mean Ki-67 proliferation index of 50.9%±24.2%. Eight patients (44.4%) were diagnosed with CNS involvement at an initial MM diagnosis and 10 (55.6%) at relapse/progression. The median time from MM diagnosis to CNS MM diagnosis was 23.5(14.3,36.0)months. The median overall survival (OS) from the onset of CNS involvement for the entire group was 18.0(95%CI: 7.3－28.7)months. The univariate analysis indicated that the patients with high-risk cytogenetic abnormality by FISH (7.0 months vs 24.0 months, P=0.007) and those with a Ki-67 proliferation index of ＞50% (13.0 months vs 29.5 months, P=0.042) had shorter OS. Conclusion A CNS imaging screening should be considered at initial diagnosis and relapse/progression of MM. Patients with CNS MM had invasive biological characteristics and the prognosis was generally poor. High-risk cytogenetic abnormality by FISH and a Ki-67 proliferation index of ＞50% were associated with worse OS.

Key words: multiple myeloma, central nervous system, clincical characteristics, prognosis

CLC Number:

Jia Jing, Chen Wenming, Li Yanchen. Clinical characteristics and prognostic analysis of multiple myeloma involving central nervous system[J]. Journal of Capital Medical University, 2023, 44(1): 161-166.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2023.01.024

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2023/V44/I1/161

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