Central nervous system involvement by multiple myeloma: A multi‐institutional retrospective study of 172 patients in daily clinical practice
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- Artur Jurczyszyn
- Jagiellonian University Medical College Cracow Poland
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- Norbert Grzasko
- Department of Hematooncology and Bone Marrow Transplantation Medical University of Lublin Lublin Poland
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- Alessandro Gozzetti
- Azienda Ospedaliera Universitaria Senese Siena Italy
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- Jacek Czepiel
- Jagiellonian University Medical College Cracow Poland
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- Alfonso Cerase
- Azienda Ospedaliera Universitaria Senese Siena Italy
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- Vania Hungria
- Santa Casa Medical School Sao Paulo Brazil
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- Edvan Crusoe
- Santa Casa Medical School Sao Paulo Brazil
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- Ana Luiza Miranda Silva Dias
- Santa Casa Medical School Sao Paulo Brazil
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- Ravi Vij
- Washington University School of Medicine St. Louis Missouri
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- Mark A. Fiala
- Washington University School of Medicine St. Louis Missouri
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- Jo Caers
- Centre Hospitalier Universitaire de Liege Liege Belgium
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- Leo Rasche
- University Hospital Wuerzburg Wuerzburg Germany
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- Ajay K. Nooka
- Winship Cancer Institute Emory University Atlanta Georgia
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- Sagar Lonial
- Winship Cancer Institute Emory University Atlanta Georgia
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- David H. Vesole
- John Theurer Cancer Center at Hackensack UMC, New Jersey and Georgetown University Washington DC
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- Sandhya Philip
- John Theurer Cancer Center at Hackensack UMC, New Jersey and Georgetown University Washington DC
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- Shane Gangatharan
- Fremantle Hospital Fremantle Australia
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- Agnieszka Druzd‐Sitek
- Maria Sklodowska‐Curie Institute – Oncology Center Warsaw Poland
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- Jan Walewski
- Maria Sklodowska‐Curie Institute – Oncology Center Warsaw Poland
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- Alessandro Corso
- Fondazione IRCCS Policlinico San Matteo, University of Pavia Pavia Italy
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- Federica Cocito
- Fondazione IRCCS Policlinico San Matteo, University of Pavia Pavia Italy
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- Marie‐Christine M. Vekemans
- Cliniques Universitaires Saint‐Luc Brussels Belgium
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- Erden Atilla
- Ankara University Medical School Ankara Turkey
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- Meral Beksac
- Ankara University Medical School Ankara Turkey
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- Xavier Leleu
- Hopital La Miletrie CHU Poitiers France
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- Julio Davila
- Hospital Universitario de Salamanca Salamanca Spain
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- Ashraf Badros
- University of Maryland Medical Center Baltimore Maryland
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- Ekta Aneja
- Weill Cornell Medical College New York New York
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- Niels Abildgaard
- Odense University Hospital Odense Denmark
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- Efstathios Kastritis
- National and Kapodistrian University of Athens Athens Greece
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- Dorotea Fantl
- Hospital Italiano de Buenos Aires Buenos Aires Argentina
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- Natalia Schutz
- Hospital Italiano de Buenos Aires Buenos Aires Argentina
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- Tomas Pika
- University Hospital Olomouc Olomouc Czech Republic
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- Aleksandra Butrym
- Wroclaw Medical University Wroclaw Poland
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- Magdalena Olszewska‐Szopa
- Wroclaw Medical University Wroclaw Poland
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- Lidia Usnarska‐Zubkiewicz
- Wroclaw Medical University Wroclaw Poland
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- Saad Z. Usmani
- Levine Cancer Institute/Carolinas HealthCare System Charlotte NC
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- Hareth Nahi
- Karolinska University Hospital Stockholm Sweden
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- Chor S Chim
- Queen Mary Hospital University of Hong Kong Hong Kong
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- Chaim Shustik
- Royal Victoria Hospital McGill University Montreal Canada
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- Krzysztof Madry
- Medical University Warsaw Poland
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- Suzanne Lentzsch
- Columbia University Medical Center New York New York
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- Alina Swiderska
- Provincial Hospital Zielona Gora Poland
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- Grzegorz Helbig
- Silesian Medical University Katowice Poland
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- Renata Guzicka‐Kazimierczak
- Pomeranian Medical University Szczecin Poland
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- Nikoletta Lendvai
- Memorial Sloan‐Kettering Cancer Center New York New York
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- Anders Waage
- Norwegian University of Science and Technology Trondheim Norway
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- Kristian T. Andersen
- Vejle Hospital Vejle Denmark
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- Hirokazu Murakami
- Gunma University Graduate School of Health Sciences Gunma Japan
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- Sonja Zweegman
- VU University Medical Center Amsterdam the Netherlands
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- Jorge J. Castillo
- Dana‐Farber Cancer Institute Harvard Medical School Boston Massachusetts
抄録
<jats:p>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 (<jats:italic>P</jats:italic> < 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 (<jats:italic>P</jats:italic> < 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.</jats:p>
収録刊行物
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- American Journal of Hematology
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American Journal of Hematology 91 (6), 575-580, 2016-04-24
Wiley
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キーワード
詳細情報 詳細情報について
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- CRID
- 1361699996001106304
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- ISSN
- 10968652
- 03618609
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- データソース種別
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- Crossref