title: Incidence, clinical features, laboratory findings and outcome of patients with multiple myeloma presenting with extramedullary relapse.
abstract: Extramedullary plasmacytomas constitute a rare and not well studied subset of multiple myeloma (MM) relapses. We report the incidence, clinical-laboratory features and outcome of patients with MM and extramedullary relapse (ExMeR). A total of 303 patients with symptomatic MM were recorded in a 13-year period in two institutions. Twenty-eight cases of ExMeR (9%) were recorded. There was an increased frequency of elevated lactate dehydrogenase (LDH) (p = 0.026), bone plasmacytomas (p = 0.001) and fractures (p = 0.002) at diagnosis, in patients with ExMeR compared to the others. ExMeR was associated with an ominous outcome, high LDH, constitutional symptoms and a statistically significant decrease of monoclonal paraprotein compared to levels at diagnosis (p = 0.009). Prior treatment with bortezomib was associated with a decreased hazard of ExMeR (p = 0.041). Overall survival (OS) was decreased in patients with ExMeR compared to the others (38 vs. 59 months, p = 0.006). Patients with MM with ExMeR have a lower OS and their clinical and laboratory features differ from those without.
authors.affiliation: First Department of Propaedeutic Internal Medicine-Hematology Section, Laikon University Hospital, Athens, Greece.
authors.forename: Xenofon
authors.initials: X
authors.lastname: Papanikolaou
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Repousis
authors.forename: Tatiana
authors.initials: T
authors.lastname: Tzenou
authors.forename: Dimitris
authors.initials: D
authors.lastname: Maltezas
authors.forename: Maria
authors.initials: M
authors.lastname: Kotsopoulou
authors.forename: Katerina
authors.initials: K
authors.lastname: Megalakaki
authors.forename: Maria
authors.initials: M
authors.lastname: Angelopoulou
authors.forename: Elektra
authors.initials: E
authors.lastname: Dimitrakoloulou
authors.forename: Efstathios
authors.initials: E
authors.lastname: Koulieris
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Bartzis
authors.forename: Gerasimos
authors.initials: G
authors.lastname: Pangalis
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Panayotidis
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Kyrtsonis
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000473:pathology*; D010954:Plasmacytoma / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D011379:Prognosis; D012008:Recurrence; D016019:Survival Analysis; D016896:Treatment Outcome