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Extramedullary intracranial localization of multiple myeloma and treatment with novel agents: A retrospective survey of 50 patients
Author(s) -
Gozzetti Alessandro,
Cerase Alfonso,
Lotti Flavia,
Rossi Davide,
Palumbo Antonio,
Petrucci Maria Teresa,
Patriarca Francesca,
Nozzoli Chiara,
Cavo Michele,
Offidani Massimo,
Floridia Michele,
Berretta Salvatore,
Vallone Roberto,
Musto Pellegrino,
Lauria Francesco
Publication year - 2011
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.26447
Subject(s) - medicine , thalidomide , multiple myeloma , lenalidomide , bortezomib , beta 2 microglobulin , autologous stem cell transplantation , surgery , chemotherapy , oncology , gastroenterology
BACKGROUND: Intracranial involvement in multiple myeloma is extremely rare. The effect of new drugs (eg, thalidomide, bortezomib, lenalidomide) with respect to old drugs (eg, alkylators, steroids) has not been reported. METHODS: We collected clinical and biological data of patients presenting with an osteo‐dural or primary dural multiple myeloma (OD‐DMM) or a central nervous system myelomatosis (CNS‐MM) by sending a questionnaire to the centers of the Gruppo Italiano Malattie Ematologiche dell'Adulto (GIMEMA). RESULTS: A total of 50 patients were registered. New therapies were used in 35 patients, whereas 15 patients received old treatments. Twenty‐five out of 50 patients obtained a complete remission or a very good partial remission (CR+VGPR). Overall survival (OS) for CNS‐MM was 6 months, for OD‐DMM 25 months. OS was 25 months for patients treated with new agents versus 8 months with old agents. Improved OS and progression‐free survival were predicted by response (CR+VGPR) and by patients who underwent stem cell transplantation versus chemotherapy. β2‐Microglobulin >5 mmol/L was a poor prognostic factor. Multivariate analysis showed poor survival for patients with β2‐microglobulin >5 mmol/L and better survival for patients achieving CR+VGPR. CONCLUSIONS: The overall data highlight the relevance of therapy with new drugs in intracranial myeloma, providing a framework for future clinical trials. Cancer 2011;. © 2011 American Cancer Society.