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Myelomatous meningitis
Author(s) -
Chamberlain Marc C.,
Glantz Michael
Publication year - 2008
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.23330
Subject(s) - medicine , meningitis , multiple myeloma , surgery , cancer , progressive disease , spinal cord compression , cerebrospinal fluid , chemotherapy , lumbar puncture , lumbar , radiation therapy , spinal cord , psychiatry
BACKGROUND The most frequent nervous system complications of multiple myeloma are peripheral neuropathy and epidural spinal cord compression. Myelomatous meningitis (MM) has been considered rare. The current study was performed to characterize the clinical presentation, treatment, and outcome of MM. METHODS The study was a case series of 14 patients with cerebrospinal fluid (CSF)‐positive MM who were treated at a tertiary care university medical center. RESULTS Fourteen patients with advanced multiple myeloma were treated with involved‐field radiotherapy (to the brain in 5 patients and the spine in 6 patients) and intra‐CSF chemotherapy (ventricular in 10 patients and lumbar in 4 patients). The best response to treatment included 6 partial responses and 8 patients with progressive disease. The median duration of response was 2.5 months (range, 0–6 months). Cause of death was progressive neurologic disease in 6 patients, combined systemic and neurologic disease in 6 patients, and systemic disease progression in 2 patients. CONCLUSIONS MM is rare and morbid entity (6‐month neurologic disease progression‐free survival rate of 7%), and appears to be no more responsive to treatment than solid tumor carcinomatous meningitis. Cancer 2008. © 2008 American Cancer Society.