Stage III multiple myeloma: clinical and prognostic value of spinal bone marrow MR imaging.
OBJECTIVE
To determine the clinical and prognostic value of spinal bone marrow magnetic resonance (MR) imaging in stage III multiple myeloma.


METHODS
In 80 patients with untreated, newly diagnosed stage III multiple myeloma, initial MR imaging patterns of spinal bone marrow involvement were correlated with hematologic parameters and response to induction chemotherapy. The influence of these patterns on survival was studied in 57 patients who did not undergo cytotoxic therapy with stem cell transplantation.


RESULTS
MR imaging patterns of marrow involvement were normal in 19 (24%) patients, focal in 35 (44%), and diffuse in 26 (32%). Patients with the diffuse pattern had higher marrow plasmacytosis (P < or = .003) and cellularity (P < or = .001), higher serum calcium (P < or = .005) and beta 2-microglobulin (P < or = .008) levels, and lower hemoglobin values (P < or = .001) than did those with the normal or focal patterns. Patients with the normal pattern responded better to therapy (P = .007) and survived longer than patients with an abnormal pattern (P = .026). MR imaging findings and C-reactive protein level were the best independent prognostic indicators of survival.


CONCLUSIONS
MR imaging patterns of spinal bone marrow involvement are correlated with several clinical parameters of disease severity and have prognostic value in stage III multiple myeloma.
Lecouvet
F E
FE
Department of Radiology and Medical Imaging, Saint Luc University Hospital, Brussels, Belgium.
Vande Berg
B C
BC
Michaux
L
L
Malghem
J
J
Maldague
B E
BE
Jamart
J
J
Ferrant
A
A
Michaux
J L
JL
D000328:Adult; D000368:Aged; D001853:Bone Marrow / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D013131:Spine; D015996:Survival Rate