Prognostic significance of focal lesions in whole-body magnetic resonance imaging in patients with asymptomatic multiple myeloma.
OBJECTIVE
With whole-body magnetic resonance imaging (wb-MRI), almost the whole bone marrow compartment can be examined in patients with monoclonal plasma cell disease. Focal lesions (FLs) detected by spinal MRI have been of prognostic significance in symptomatic multiple myeloma (sMM). In this study, we investigated the prognostic significance of FLs in wb-MRI in patients with asymptomatic multiple myeloma (aMM).


METHODS
Wb-MRI was performed in 149 patients with aMM. The prognostic significance of the presence and absence, as well as the number, of FLs for progression into sMM was analyzed.


RESULTS
FLs were present in 28% of patients. The presence per se of FLs and a number of greater than one FL were the strongest adverse prognostic factors for progression into sMM (P < .001) in multivariate analysis. A diffuse infiltration pattern in MRI, a monoclonal protein of 40 g/L or greater, and a plasma cell infiltration in bone marrow of 20% or greater were other adverse prognostic factors for progression-free survival in univariate analysis.


CONCLUSIONS
We recommend use of wb-MRI for risk stratification of patients with asymptomatic multiple myeloma.
Hillengass
Jens
J
Department of Hematology and Oncology, University Hospital Heidelberg, Heidelberg, Germany. Jens.Hillengass@med.uni-heidelberg.de
Fechtner
Kerstin
K
Weber
Marc-André
MA
Bäuerle
Tobias
T
Ayyaz
Sofia
S
Heiss
Christiane
C
Hielscher
Thomas
T
Moehler
Thomas M
TM
Egerer
Gerlinde
G
Neben
Kai
K
Ho
Anthony D
AD
Kauczor
Hans-Ulrich
HU
Delorme
Stefan
S
Goldschmidt
Hartmut
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis*; D011379:Prognosis; D018570:Risk Assessment; D016019:Survival Analysis; D051598:Whole Body Imaging