Journal of Yeungnam Medical Science

Original article

Clinical impact of spine magnetic resonance imaging as a valuable prognostic tool for patients with multiple myeloma: a retrospective study: Jung Min Lee, Hee Jeong Cho, Joon-Ho Moon, Sang Kyun Sohn, Byunggeon Park, Dong Won Baek; J Yeungnam Med Sci. 2022;39(4):300-308. Published online March 23, 2022; DOI: https://doi.org/10.12701/jyms.2021.01648

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Background
This study investigated the prognostic impact of spine magnetic resonance imaging (MRI) in patients newly diagnosed with multiple myeloma (MM).
Methods
We retrospectively evaluated 214 patients who were newly diagnosed with MM between March 2015 and December 2019. The patients were classified into five different infiltration patterns based on spine MRI as follows: (1) normal appearance, (2) focal, (3) diffuse, (4) combined focal and diffuse infiltration, and (5) “salt-and-pepper.”
Results
Forty patients (18.7%) showed a normal appearance, whereas focal, diffuse, combined focal and diffuse infiltration, and “salt-and-pepper” patterns were identified in 68 (31.8%), 40 (18.7%), 52 (24.3%), and 14 patients (6.5%), respectively. The patients with normal and “salt-and-pepper” patterns were younger than patients with other patterns (median age, 61.6 vs. 66.8 years; p=0.001). Moreover, 63% and 59.3% of patients with normal and “salt-and-pepper” patterns were scored International Staging System (ISS) stage I and revised ISS (R-ISS) stage I, respectively, whereas only 12.5% of patients with other patterns were scored ISS stage I and R-ISS stage I. Patients with normal and “salt-and-pepper” patterns had a better prognosis than those with other patterns, whereas relapse and death rates were significantly higher in patients with focal, diffuse, and combined MRI patterns.
Conclusion
Characteristic MRI findings have a significant prognostic value for long-term survival in patients newly diagnosed with MM. In particular, focal, diffuse, and combined focal and diffuse infiltration patterns are unfavorable prognostic factors.

Citations

Citations to this article as recorded by

Lesions of the spinal cord caused by multiple myeloma: A systematic review and meta-analysis regarding the neurosurgical aspects of patient management
Daniel Encarnacion, Gennady E Chmutin, Ismail Bozkurt, Jack Wellington, Emmanuel Batista Geraldino, Bipin Chaurasia
Journal of Craniovertebral Junction and Spine.2023; 14(4): 313. CrossRef

Original Article

Chemotherapy adherence is a favorable prognostic factor for elderly patients with multiple myeloma who are treated with a frontline bortezomib-containing regimen: Hee-Jeong Cho, Sang-Kyung Seo, Dong Won Baek, Sung-Woo Park, Yoo-Jin Lee, Sang-Kyun Sohn, Ho-Sup Lee, Won Sik Lee, Ji Hyun Lee, Sung Hyun Kim, Joon-Ho Moon; Yeungnam Univ J Med. 2018;35(1):76-83. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.76

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Abstract PDF

Background
Elderly patients with multiple myeloma (MM) are vulnerable to adverse events (AEs). This study evaluated adherence to chemotherapy and treatment outcomes in elderly patients treated with a frontline bortezomib (BTZ), melphalan, and prednisone (VMP) regimen and regimens without BTZ.
Methods
One-hundred and forty elderly patients who were diagnosed with MM from March 2007 to March 2015 were included in this retrospective study. To evaluate regimen adherence, patients who were treated with more than 4 cycles were assigned to the good adherence group.
Results
Among the 140 patients, 71 were treated with a frontline VMP and 69 with non-BTZ regimens. The median age was 71 years (range, 65-90 years). The VMP group showed a higher complete response rate than the non-BTZ group: 26.8% vs. 7.2%. More patients in the VMP group achieved ≥very good partial response (VGPR) and ≥PR. In the VMP group, 27 patients (38.0%) received less than 4 cycles. The VMP good adherence group showed a higher 3-year overall survival (OS) rate (70.9%) than the poor adherence group (60.2%, p=0.059). In the multivariate analysis, treatment with ≥4 cycles of VMP was a favorable factor for OS.
Conclusion
A good adherence to a frontline VMP regimen resulted in favorable long-term survival. Adequate management of AEs will be needed to achieve favorable outcomes in elderly patients with MM.

Citations

Citations to this article as recorded by

Solomon Islands Oncology Unit: Sustainability in Terms of Outcomes
Dylan Bush, Mark Love, Hugo Bugoro, Nixon Panda
JCO Global Oncology.2024;[Epub] CrossRef
Real World Adherence to and Persistence With Oral Oncolytics in Multiple Myeloma: A Systematic Review and Meta-analysis
Abdallah Y. Naser, Richard Ofori-Asenso, Safaa Al Awawdeh, Sami Qadus, Hassan Alwafi, Danny Liew
Clinical Lymphoma Myeloma and Leukemia.2022; 22(10): 760. CrossRef
Oral therapy adherence and satisfaction in patients with multiple myeloma
Marine Solano, Etienne Daguindau, Cyril Faure, Pierre Loriod, Coline Pain, Anne-Cécile Maes, Pauline Marguet, Marie Kroemer, Anne Rumpler, Jean Fontan, Eric Deconinck, Samuel Limat, Anne-Laure Clairet
Annals of Hematology.2021; 100(7): 1803. CrossRef

Case Report

A Case of Multiple Myeloma with AL Amyloidosis Successfully Treated with Autologous Stem Cell Transplantation: Ha-young Lee, Kyung Hee Lee, Min Kyoung Kim, Hee Soon Cho, Myung Soo Hyun; Yeungnam Univ J Med. 2007;24(2 Suppl):S676-682. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S676

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Abstract PDF: Myeloma is a disease of neoplastic B lymphocytes that synthesize abnormal amounts of immunoglobulin (Ig) or Ig fragments. Ten to twenty percent of myeloma patients are known to develop clinical evidence of amyloid-light chain(AL) amyloidosis. A high index of suspicion, however, is needed to make a diagnosis of amyloidosis. We report a case of multiple myeloma with AL amyloidosis successfully treated with autologous stem cell transplantation. In our case, the patient presented with longstanding abdominal discomfort and anterior chest pain. Chest X-ray showed several osteolytic changes on ribs. Endoscopic biopsy revealed massive amyloid deposits in the wall of stomach and rectum. Serum/urine protein electroporesis and bone marrow biopsy confirmed the diagnosis of multiple myeloma. At 18 months after high dose chemotherapy and autologous stem cell transplantation(ASCT), the patient maintained a complete response. In patients with multiple myeloma with AL amyloidosis, high dose chemotherapy and ASCT can be effective treatment strategy.

Original Article

A clinical study on multiple myeloma.: Hyeong Ki Hwang, Choong Ki Lee, Myung Soo Hyun, Bong Sup Shim, Hyun Woo Lee; Yeungnam Univ J Med. 1991;8(2):106-113. Published online December 31, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.2.106

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Abstract PDF: A clinical review of 31 cases of multiple myeloma which were diagnosed by criteria of the SWOG between May 1983 and February 1990 at Yeungnam University Hospital was done. The results were as followings: 1. The peak incidence was in 7th decade and male to female ratio was 1.8:1. 2. The most common presenting symptom at first diagnosis was bone pain (58%), but fever, dyspnea, dizziness and palpable mass were also noted. 3. The distribution of laboratory findings as following diagnostic criteria of Southwest oncology group (SWOG): Plasmacytoma on tissue biopsy was noted 6 cases, bone marrow plasmacytosis with more than 10% plasma cells was 22 cases, monoclonal globulin spike on serum electrophoresis was 24 cases, lytic bone lesions was observed 22 cases. 4. Initial clinical stages were classified as 2 cases in stage I, 3 cases in stage II, 26 cases in stage III (84%). 5. Immunoelectrophoresis revealed the distribution of IgG 64%, light chain 22%, IgA 10%, Kappa to Lambda ratio of 1.1:1. 6. Hematologic & biochemical findings revealed anemia with <8.5% of hemoglobin in 42%, hypercalcemia with <10.6 mg% of serum calcium in 22%, azotemia >2.0 mg% of serum creatinine in 19%. 7. The multiple punched out lesion of bone x-ray examination were noticed skull (65%), rib (42%), L-spine (35%), pelvis (23%), T-spine (19%). The initial skeletal roentgenographic findings showed osteoporosis, osteolytic lesion and fracture in 55%, only osteolytic lesion in 23%, only osteoporosis in 10%. 8. Complications of multiple myeloma, such as 10 cases of renal impairment, 8 cases of infection, 16 cases of compression fracture of spine were observed.

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