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- Title
Magnetic resonance imaging pattern of bone marrow involvement as a new predictive parameter of disease progression in newly diagnosed patients with multiple myeloma eligible for autologous stem cell transplantation.
- Authors
Song, Moo‐Kon; Chung, Joo‐Seop; Lee, Je‐Jung; Min, Chang‐Ki; Ahn, Jae‐Sook; Lee, Sang‐Min; Shin, Dong‐Yeop; Bae, Sung‐Hwa; Hong, Junshik; Lee, Gyeong‐won; Lee, In‐Sook; Shin, Ho‐Jin
- Abstract
We investigated the prognostic value of the magnetic resonance imaging ( MRI) pattern of bone marrow involvement in patients with multiple myeloma ( MM) eligible for autologous stem cell transplantation ( ASCT). 126 patients with untreated MM indicated for ASCT underwent spine MRI and cytogenetic analysis at diagnosis. All patients received ASCT after induction therapy of VAD (vincristine, doxorubicin, dexamethasone; n = 55) or a thalidomide-based regimen ( TCD; n = 71). Thalidomide maintenance therapy was performed in 68 patients. The MRI pattern was normal in 27, focal in 47, and diffuse/variegated in 52 patients. Patients with the diffuse/variegated pattern showed significantly higher stage ( P = 0·038), higher β-2 microglobulin level ( P = 0·001) and severe anaemia ( P = 0·015). However, the cytogenetics were not different among the MRI patterns ( P = 0·890). Progression-free survival ( PFS) was lower in the diffuse/variegated pattern ( P = 0·002) than other patterns, but not overall survival ( OS) ( P = 0·058). Thalidomide maintenance therapy was correlated only with PFS ( P = 0·001). High-risk cytogenetics were associated with both poorer PFS ( P < 0·001) and OS ( P = 0·003). In a multivariate analysis, the diffuse/variegated MRI pattern was an independent predictor of disease progression (Hazard Ratio, 1·922; 95% confidence interval, 1·185-3·118; P = 0·008). The diffuse/variegated MRI pattern is a novel prognostic factor for disease progression in MM patients eligible for ASCT.
- Subjects
MAGNETIC resonance imaging; BONE marrow; DISEASE progression; AUTOGRAFTS; STEM cell transplantation; MULTIPLE myeloma; PATIENTS
- Publication
British Journal of Haematology, 2014, Vol 165, Issue 6, p777
- ISSN
0007-1048
- Publication type
Article
- DOI
10.1111/bjh.12820