The possible role of burden of therapy on the risk of myeloma extramedullary spread

S. Mangiacavalli, A. Pompa, V. Ferretti, C. Klersy, F. Cocito, M. Varettoni, C. S. Cartia, M. Cazzola, A. Corso

Research output: Contribution to journalArticlepeer-review


Extramedullary relapse (EMR) represents a poor prognostic marker in the course of multiple myeloma (MM). We reviewed data from 329 patients, diagnosed between 2000 and 2010, without extramedullary disease at onset to explore possible risk factors for EMR. The median overall survival of our study cohort was 6.4 years. The risk of EMR was 28 % with a median time from diagnosis to first EMR of 2.2 years (0.2-9.1 years). Patients with soft tissue masses located in extra-osseous organs (EMR-S) showed the worst outcome, compared to those with tumor masses arising from adjacent bone (EMR-B) (median OS 1.6 vs 2.4 years, p = 0.006). In addition, patients with EMR-S showed a significant trend for further development of extramedullary masses in a very short time (3.7 vs 5.7 months for EMR-B, p = 0.043). Multivariate analysis failed to identify any clinically presenting features predictive for EMR. The occurrence of EMR was higher in patients with more complex treatment history, defined on the basis of longer treatment duration (>/=6 vs 2 vs
Original languageEnglish
Pages (from-to)73-80
Number of pages8
JournalAnnals of Hematology
Issue number1
Publication statusPublished - Jan 1 2017


  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols/administration & dosage
  • Bortezomib/administration & dosage
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Multiple Myeloma/diagnosis/drug therapy/mortality
  • Neoplasm Recurrence, Local/diagnosis/drug therapy/mortality
  • Retrospective Studies
  • Risk Factors
  • Sarcoma, Myeloid/diagnosis/drug therapy/mortality
  • Survival Rate/trends
  • Thalidomide/administration & dosage/analogs & derivatives
  • Extramedullary
  • Myeloma
  • Novel agents
  • Relapse


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