Impact of extramedullary disease in patients with newly diagnosed multiple myeloma undergoing autologous stem cell transplantation: A study from the Chronic Malignancies Working Party of the EBMT
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Impact of extramedullary disease in patients with newly diagnosed multiple myeloma undergoing autologous stem cell transplantation: A study from the Chronic Malignancies Working Party of the EBMT. / Gagelmann, Nico; Eikema, Diderik-Jan; Iacobelli, Simona; Koster, Linda; Nahi, Hareth; Stoppa, Anne-Marie; Masszi, Tamás; Caillot, Denis; Lenhoff, Stig; Udvardy, Miklos; Crawley, Charles; Arcese, William; Mariette, Clara; Hunter, Ann; Leleu, Xavier; Schipperus, Martin; Delforge, Michel; Pioltelli, Pietro; Snowden, John A; Itälä-Remes, Maija; Musso, Maurizio; van Biezen, Anja; Garderet, Laurent; Kröger, Nicolaus.
In: HAEMATOLOGICA, Vol. 103, No. 5, 05.2018, p. 890-897.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Impact of extramedullary disease in patients with newly diagnosed multiple myeloma undergoing autologous stem cell transplantation: A study from the Chronic Malignancies Working Party of the EBMT
AU - Gagelmann, Nico
AU - Eikema, Diderik-Jan
AU - Iacobelli, Simona
AU - Koster, Linda
AU - Nahi, Hareth
AU - Stoppa, Anne-Marie
AU - Masszi, Tamás
AU - Caillot, Denis
AU - Lenhoff, Stig
AU - Udvardy, Miklos
AU - Crawley, Charles
AU - Arcese, William
AU - Mariette, Clara
AU - Hunter, Ann
AU - Leleu, Xavier
AU - Schipperus, Martin
AU - Delforge, Michel
AU - Pioltelli, Pietro
AU - Snowden, John A
AU - Itälä-Remes, Maija
AU - Musso, Maurizio
AU - van Biezen, Anja
AU - Garderet, Laurent
AU - Kröger, Nicolaus
N1 - Copyright © 2018, Ferrata Storti Foundation.
PY - 2018/5
Y1 - 2018/5
N2 - We investigated extramedullary disease in newly diagnosed multiple myeloma patients and its impact on outcome following first-line autologous stem cell transplantation. We identified 3744 adult myeloma patients who received up-front single (n=3391) or tandem transplantation (n=353) between 2005 and 2014 with available data on extramedullary involvement at diagnosis. The overall incidence of extramedullary disease was 18.2% (n=682) and increased per year from 6.5% (2005) to 23.7% (2014). Paraskeletal involvement was found in 543 (14.5%) and extramedullary organ involvement in 139 (3.7%). More patients with extramedullary organ involvement had multiple involved sites (≥2; P<0.001). In a comparison of patients with single sites with patients without the disease, up-front transplantation resulted in at least similar 3-year progression-free survival (paraskeletal: P=0.86, and extramedullary organ: P=0.88). In single paraskeletal involvement, this translated less clearly into worse 3-year overall survival (P=0.07) while single organ involvement was significantly worse (P=0.001). Multiple organ sites were associated with worse outcome (P<0.001 and P=0.01). First-line treatment with tandem compared with single transplantation resulted in similar survival in patients with extramedullary disease at diagnosis (P=0.13 for both).
AB - We investigated extramedullary disease in newly diagnosed multiple myeloma patients and its impact on outcome following first-line autologous stem cell transplantation. We identified 3744 adult myeloma patients who received up-front single (n=3391) or tandem transplantation (n=353) between 2005 and 2014 with available data on extramedullary involvement at diagnosis. The overall incidence of extramedullary disease was 18.2% (n=682) and increased per year from 6.5% (2005) to 23.7% (2014). Paraskeletal involvement was found in 543 (14.5%) and extramedullary organ involvement in 139 (3.7%). More patients with extramedullary organ involvement had multiple involved sites (≥2; P<0.001). In a comparison of patients with single sites with patients without the disease, up-front transplantation resulted in at least similar 3-year progression-free survival (paraskeletal: P=0.86, and extramedullary organ: P=0.88). In single paraskeletal involvement, this translated less clearly into worse 3-year overall survival (P=0.07) while single organ involvement was significantly worse (P=0.001). Multiple organ sites were associated with worse outcome (P<0.001 and P=0.01). First-line treatment with tandem compared with single transplantation resulted in similar survival in patients with extramedullary disease at diagnosis (P=0.13 for both).
KW - Journal Article
U2 - 10.3324/haematol.2017.178434
DO - 10.3324/haematol.2017.178434
M3 - SCORING: Journal article
C2 - 29419433
VL - 103
SP - 890
EP - 897
JO - HAEMATOLOGICA
JF - HAEMATOLOGICA
SN - 0390-6078
IS - 5
ER -