Incidence, prognostic significance and therapeutic modalities of central nervous system involvement in multiple myeloma.
In 114 patients with systemic malignant gammopathies followed during a 10-year period in the hematology clinic of the Rambam Medical Center, 23 episodes of CNS involvement were recorded. 19 cases with spinal cord compression and 4 cases of intracranial plasmacytomas. Early diagnosis followed by prompt laminectomy and subsequent radiotherapy resulted in complete recovery in 50% and partial improvement in 30% of the patients with spinal cord involvement. In good responders. overall survival was not affected by the neurological complication. In the 4 patients with intracranial involvement, external plasmacytomas of the skull preceded the neurological symptoms. 3 of them were diagnosed late, which led to delay and failure of accurate treatment. Only 1 patient was immediately operated and continued to be well for the past 2 years.
D000368:Aged; D002493:Central Nervous System Diseases / Q000209:etiology* / Q000532:radiotherapy / Q000601:surgery; D003399:Craniotomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications*; D010954:Plasmacytoma / Q000209:etiology / Q000532:radiotherapy / Q000601:surgery; D011379:Prognosis; D012888:Skull Neoplasms / Q000209:etiology / Q000532:radiotherapy / Q000601:surgery; D013117:Spinal Cord Compression / Q000209:etiology / Q000532:radiotherapy / Q000601:surgery