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.
Extramedullary intracranial localization of multiple myeloma and treatment with novel agents: a retrospective survey of 50 patients / Alessandro Gozzetti; Alfonso Cerase; Flavia Lotti; Davide Rossi; Antonio Palumbo; Maria Teresa Petrucci; Francesca Patriarca; Chiara Nozzoli; Michele Cavo; Massimo Offidani; Michele Floridia; Salvatore Berretta; Roberto Vallone; Pellegrino Musto; Francesco Lauria; and for the GIMEMA (Gruppo Italiano Malattie Ematologiche dell'Adulto) Myeloma Working Party; additional authors who participated to the study: Elena Marchini; Alberto Fabbri; Stefania Oliva; Elena Zamagni; Fabiana Gentilini; Stelvio Ballanti; Giuseppe Mele; Monica Galli; Maria Teresa Pirrotta; Francesco Di Raimondo. - In: CANCER. - ISSN 0008-543X. - STAMPA. - 118:6(2012), pp. 1574-1584. [10.1002/cncr.26447]
Extramedullary intracranial localization of multiple myeloma and treatment with novel agents: a retrospective survey of 50 patients
CAVO, MICHELE;ZAMAGNI, ELENA;
2012
Abstract
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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
