Details

Autor(en) / Beteiligte

• Yamashita, Takeshi
• Takamatsu, Hiroyuki
• Kawamura, Koji
• Sunami, Kazutaka
• Hagiwara, Shotaro
• Itagaki, Mitsuhiro
• Takahashi, Tsutomu
• Kondo, Tadakazu
• Ikeda, Takashi
• Watakabe‐Inamoto, Kyoko
• Handa, Hiroshi
• Imaizumi, Yoshitaka
• Kuroda, Junya
• Murakami, Jun
• Nakamura, Yuichi
• Nakazawa, Hideyuki
• Ozaki, Shuji
• Okura, Miyuki
• Takeuchi, Masami
• Nagai, Hirokazu
• Hanamura, Ichiro
• Nakao, Shinji
• Iida, Shinsuke

Titel

A nationwide survey on central nervous system multiple myeloma in Japan: analysis of prognostic and treatment factors that impact survival

Ist Teil von

• British journal of haematology, 2021-10, Vol.195 (2), p.217-229

Ort / Verlag

England: Blackwell Publishing Ltd

Erscheinungsjahr

2021

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Summary This nationwide multicentre retrospective study was performed to analyze clinical features that predict the prognosis of central nervous system invasion in multiple myeloma (CNS‐MM, approximately 1% of MM). Overall, of the 77 adult patients with CNS‐MM identified between 2005 and 2016, those diagnosed at MM diagnosis (n = 3) had longer overall survival (OS) than those diagnosed at relapse (n = 74; median: 48·5 vs 2·7 months). Therefore, we compared the relapsed MM with CNS‐MM in patients with any treatment (n = 60). Multivariate analyses revealed that lenalidomide treatment [hazard ratio (HR) 0·27, P = 0·003], intrathecal chemotherapy (IT; HR 0·54, P = 0·05), and radiation therapy (RTx; HR 0·33, P < 0·001) for CNS‐MM had a positive effect on longer OS. These factors were used to develop a scoring system combining the number of treatments with lenalidomide, IT, and RTx (0, 1, 2, 3). The OS of CNS‐MM patients was stratified based on these factors, with a median OS of 1·1, 4·5, and 7·5 months for patients with zero, one, two to three favourable features, respectively (0 vs 1, P = 0·0002; 1 vs 2–3, P = 0·08). Multimodal treatment including lenalidomide in addition to conventional IT and RTx can improve OS.