In:
British Journal of Haematology, Wiley, Vol. 165, No. 6 ( 2014-06), p. 777-785
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 .
Type of Medium:
Online Resource
ISSN:
0007-1048
,
1365-2141
DOI:
10.1111/bjh.2014.165.issue-6
Language:
English
Publisher:
Wiley
Publication Date:
2014
detail.hit.zdb_id:
1475751-5