What question did this study set out to answer?

To evaluate clinical outcomes, therapeutic efficacy, and predictors for the development of de novo versus secondary extramedullary multiple myeloma.

July 8, 2023American Journal of HematologyOpen Access

Natural history, predictors of development of extramedullary disease, and treatment outcomes for patients with extramedullary multiple myeloma

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Authors

SZSaurabh ZanwarMayo Clinic MHMatthew HoNorthwell Health YLYi LinSouth China Agricultural University

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Implication

Retrospective cohort reveals inferior survival and risk predictors in extramedullary multiple myeloma, highlighting poor long-term efficacy of novel therapies.

Key Points

To evaluate clinical outcomes, therapeutic efficacy, and predictors for the development of de novo versus secondary extramedullary multiple myeloma.
Retrospective cohort analysis of 299 patients (excluding paraskeletal disease and primary plasma cell leukemia) diagnosed between January 1, 2000, and December 31, 2021, comprising 95 with de novo and 204 with secondary extramedullary disease.
Evaluated outcomes with novel therapies including CAR-T therapy (n = 20) and bispecific antibodies (n = 12), and performed multivariate logistic regression in a matched cohort to identify predictors.
Median overall survival was 0.7 years (95% CI: 0.6–0.9) for secondary and 3.6 years (95% CI: 2.4–5.6) for de novo disease; median initial PFS was 2.9 months (95% CI: 2.4–3.2) versus 12.9 months (95% CI: 6.7–18), respectively.
CAR-T therapy achieved a ≥ partial response rate of 75% with a median PFS of 4.9 months (3.1 months–NR) in secondary disease, while bispecific antibodies yielded a 33% response rate with a median PFS of 2.9 months (95% CI: 2.2 months–NR).
Presence of extramedullary disease independently predicted inferior OS in de novo (HR 2.9 [95% CI: 1.6–5.4], p = .0007) and secondary cohorts (HR 1.5 [95% CI: 1.1–2], p = .001); younger age, 1q duplication, and t(4;14) independently predicted secondary progression.

Cite This Study

Zanwar et al. (2023) studied this question.

synapsesocial.com/papers/6a6e108f8031ec7bb1db711c https://doi.org/10.1002/ajh.27023

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Implication

Retrospective cohort reveals inferior survival and risk predictors in extramedullary multiple myeloma, highlighting poor long-term efficacy of novel therapies.

Natural history, predictors of development of extramedullary disease, and treatment outcomes for patients with extramedullary multiple myeloma

Discussion

Member takes

Implication

Key Points

Cite This Study

Natural history, predictors of development of extramedullary disease, and treatment outcomes for patients with extramedullary multiple myeloma

Discussion

Member takes

Implication

Key Points

Cite This Study

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