Premium
Magnetic resonance imaging pattern of bone marrow involvement as a new predictive parameter of disease progression in newly diagnosed patients with multiple myeloma eligible for autologous stem cell transplantation
Author(s) -
Song MooKon,
Chung JooSeop,
Lee JeJung,
Min ChangKi,
Ahn JaeSook,
Lee SangMin,
Shin DongYeop,
Bae SungHwa,
Hong Junshik,
Lee Gyeongwon,
Lee InSook,
Shin HoJin
Publication year - 2014
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.12820
Subject(s) - medicine , thalidomide , autologous stem cell transplantation , multiple myeloma , hazard ratio , transplantation , magnetic resonance imaging , oncology , bone marrow , pathology , radiology , confidence interval
Summary We investigated the prognostic value of the magnetic resonance imaging ( MRI ) pattern of bone marrow involvement in patients with multiple myeloma ( MM ) eligible for autologous stem cell transplantation ( ASCT ). 126 patients with untreated MM indicated for ASCT underwent spine MRI and cytogenetic analysis at diagnosis. All patients received ASCT after induction therapy of VAD (vincristine, doxorubicin, dexamethasone; n = 55) or a thalidomide‐based regimen ( TCD ; n = 71). Thalidomide maintenance therapy was performed in 68 patients. The MRI pattern was normal in 27, focal in 47, and diffuse/variegated in 52 patients. Patients with the diffuse/variegated pattern showed significantly higher stage ( P = 0·038), higher β‐2 microglobulin level ( P = 0·001) and severe anaemia ( P = 0·015). However, the cytogenetics were not different among the MRI patterns ( P = 0·890). Progression‐free survival ( PFS ) was lower in the diffuse/variegated pattern ( P = 0·002) than other patterns, but not overall survival ( OS ) ( P = 0·058). Thalidomide maintenance therapy was correlated only with PFS ( P = 0·001). High‐risk cytogenetics were associated with both poorer PFS ( P < 0·001) and OS ( P = 0·003). In a multivariate analysis, the diffuse/variegated MRI pattern was an independent predictor of disease progression (Hazard Ratio, 1·922; 95% confidence interval, 1·185–3·118; P = 0·008). The diffuse/variegated MRI pattern is a novel prognostic factor for disease progression in MM patients eligible for ASCT .