title: [Clinical features and outcome analyses of newly-diagnosed multiple myeloma with extramedullary involvements].
abstract: OBJECTIVE
  To explore the clinical features and prognostic factors of newly-diagnosed multiple myeloma (MM) with extramedullary (EM) involvements.
  
  
  METHODS
  The clinical features, efficacies, survival rates and prognostic factors were retrospectively analyzed in 46 MM patients with EM (group A) from January 2000 to October 2011. And another 53 MM patients without EM (group B) were selected as the controls.
  
  
  RESULTS
  The median age of Group A was 58 years. Compared with group B, the incidence of EM was associated with a higher level of β2-microglobulin (β2-MG) and extensive bone disease. The most common location of EM was soft tissues. And the total effective rates of groups A and B were 58.5% (24/41) and 78.8% (41/52) respectively. The difference was statistically significant (P = 0.042). The median follow-up time was 28(2-88) months. The estimated overall survival (OS) of the patients with EM was significantly shorter than those without EM (42.6 vs 53.9 months, P = 0.009). Log-rank univariate analysis showed that the number of osteolytic lesions ≥ 3, β2-MG ≥ 5.5 mg/L, hemoglobin ≤ 110 g/L and albumin ≤ 30 g/L were poor prognostic factors in MM patients with EM. Multivariate analysis with Cox model showed only the number of osteolytic lesions ≥ 3 (OR = 2.327, 95%CI: 1.282 - 4.224) and β2-MG ≥ 5.5 mg/L (OR = 2.677, 95%CI: 1.092 - 6.566) were statistically significant.
  
  
  CONCLUSIONS
  Multiple EM lesions may be involved in MM patients. For the patients with EM, the response to conventional chemotherapy is poor and the prognosis is unfavorable, especially for those with a high level of β2-MG or the number of osteolytic lesions ≥ 3.
authors.affiliation: Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
authors.forename: Yi-zhuo
authors.initials: YZ
authors.lastname: Zhang
authors.forename: Ya-qin
authors.initials: YQ
authors.lastname: Zhi
authors.forename: Ya-fei
authors.initials: YF
authors.lastname: Wang
authors.forename: Yong
authors.initials: Y
authors.lastname: Yu
authors.forename: Zhi-gang
authors.initials: ZG
authors.lastname: Zhao
authors.forename: Xiao-fang
authors.initials: XF
authors.lastname: Wang
authors.forename: Qiong-li
authors.initials: QL
authors.lastname: Zhai
authors.forename: Bao-cun
authors.initials: BC
authors.lastname: Sun
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000473:pathology*; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D001613:beta 2-Microglobulin / Q000032:analysis
chemical_list: D001613:beta 2-Microglobulin