Outcome of paraosseous extra-medullary disease in newly diagnosed multiple myeloma patients treated with new drugs.

Vittorio Montefusco, Francesca Gay, Stefano Spada, Lorenzo De Paoli, Francesco Di Raimondo, Rossella Ribolla, Caterina Musolino, Francesca Patriarca, Pellegrino Musto, Piero Galieni, Stelvio Ballanti, Chiara Nozzoli, Nicola Cascavilla, Dina Ben-Yehuda, Arnon Nagler, Roman Hajek, Massimo Offidani, Anna Marina Liberati, Pieter Sonneveld, Michele CavoPaolo Corradini, Mario Boccadoro

Research output: Contribution to journalArticlepeer-review

Abstract

Extramedullary disease is relatively frequent in multiple myeloma, but our knowledge on the subject is limited and mainly relies on small case series or single center experiences. Little is known regarding the role of new drugs in this setting. We performed a meta-analysis of eight trials focused on the description of extramedullary disease characteristics, clinical outcome, and response to new drugs. A total of 2,332 newly diagnosed myeloma patients have been included; 267 (11.4%) had extramedullary disease, defined as paraosseous in 243 (10.4%), extramedullary plasmocytoma in 12 (0.5%), and not classified in 12 (0.5%) patients. Median progression-free survival was 25.3 months and 25.2 in extramedullary disease and non-extramedullary disease patients, respectively. In multivariate analysis the presence of extramedullary disease did not impact on progression-free survival (hazard ratio 1.15, P=0.06), while other known prognostic factors retained their significance. Patients treated with immunomodulatory drugs, mainly lenalidomide, or proteasome inhibitors had similar progression-free survival and progression-free survival-2 regardless of extramedullary disease presence. Median overall survival was 63.5 months and 79.9 months (P=0.01) in extramedullary and non-extramedullary disease patients, respectively, and in multivariate analysis the presence of extramedullary disease was associated with a reduced overall survival (hazard ratio 1.41, P
Original languageEnglish
Pages (from-to)193-200
Number of pages8
JournalHaematologica
Volume105
Issue number1
DOIs
Publication statusPublished - 2020

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