title: Clinical and prognostic significance of bone marrow abnormalities in the appendicular skeleton detected by low-dose whole-body multidetector computed tomography in patients with multiple myeloma.
abstract: Clinical significance of medullary abnormalities in the appendicular skeleton (AS) detected by low-dose whole-body multidetector computed tomography (MDCT) in patients with multiple myeloma (MM) was investigated. A total of 172 patients with monoclonal gammopathy of undetermined significance (MGUS) (n=17), smoldering MM (n=47) and symptomatic MM (n=108) underwent low-dose MDCT. CT values (CTv) of medullary density of AS⩾0 Hounsfield unit (HU) was considered as abnormal. Percentage of medullary abnormalities and the mean CTv of AS in patients with MGUS, smoldering MM and symptomatic MM were 18, 55 and 62% and -44.5 , -20.3 and 11.2 HU, respectively (P<0.001 and P<0.001). Disease progression of MM was independently associated with high CTv on multivariate analysis. In symptomatic MM, the presence of abnormal medullary lesions was associated with increased incidence of high-risk cytogenetic abnormalities (34.4% vs 7.7%; P=0.002) and extramedullary disease (10.4% vs 0%; P=0.032). It was also an independent poor prognostic predictor (hazard ratio 3.546, P=0.04). This study showed that CTv of AS by MDCT is correlated with disease progression of MM, and the presence of abnormal medullary lesions is a predictor for poor survival.
authors.affiliation: 1] Division of Hematology/Oncology, Department of Medicine, Kameda Medical Center, Kamogawa, Japan [2] Department of Hematology, Respiratory Medicine and Oncology, Division of Internal Medicine, Saga University, Saga, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Nishida
authors.affiliation: Department of Cardiology, Kameda Medical Center, Kamogawa, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Matsue
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Kameda Medical Center, Kamogawa, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Suehara
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Kameda Medical Center, Kamogawa, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Fukumoto
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Kameda Medical Center, Kamogawa, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Fujisawa
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Kameda Medical Center, Kamogawa, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Takeuchi
authors.affiliation: Department of Radiology, Kameda Medical Center, Kamogawa, Japan.
authors.forename: E
authors.initials: E
authors.lastname: Ouchi
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Kameda Medical Center, Kamogawa, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Matsue
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001853:Bone Marrow / Q000000981:diagnostic imaging* / Q000473:pathology; D019046:Bone Marrow Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000556:secondary; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D009101:Multiple Myeloma / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models