PMID- 25640025 OWN - NLM STAT- MEDLINE DCOM- 20160127 LR - 20150424 IS - 2152-2669 (Electronic) IS - 2152-2669 (Linking) VI - 15 IP - 5 DP - 2015 May TI - Features of extramedullary disease of multiple myeloma: high frequency of p53 deletion and poor survival: a retrospective single-center study of 834 cases. PG - 286-91 LID - S2152-2650(14)00572-2 [pii] LID - 10.1016/j.clml.2014.12.013 [doi] AB - BACKGROUND: Multiple myeloma (MM) is a heterogeneous disease in which most patients have myeloma restricted to the bone marrow, and some patients develop extramedullary disease (EMD) at the time of diagnosis or during follow-up, and show different clinical characteristics and a dismal prognosis. PATIENTS AND METHODS: We studied 834 consecutive MM patients in a single center in China and compared clinical features of patients with and without EMD. RESULTS: In general, the prevalence of EMD was 4.8% at the time of diagnosis and 3.4% during follow-up, with a significant increase in recent years. MM patients with EMD at the time of diagnosis had remarkably greater prevalence of P53 deletion determined using fluorescence in situ hybridization (FISH) analysis (34.5% vs. 11.9%; P = .037) and higher level of lactate dehydrogenase (LDH) (P = .003) compared with patients without EMD. EMD relapse/progression during follow-up was correlated with EMD presentation at diagnosis, immunoglobulin (Ig)D subtype and P53 deletion in FISH analysis, but not previous treatment (thalidomide, bortizomib, or transplantation). With respect to prognosis, multivariate analysis showed that EMD was an independent adverse prognostic factor. The overall survival of patients with and without EMD at diagnosis were 16.5 and 40 months, respectively (P < .001), and the time to disease progression of the 2 groups was 11.5 and 25 months, respectively (P < .001). CONCLUSION: MM patients with EMD at the time of diagnosis showed remarkably greater prevalence of P53 deletion in FISH analysis and higher LDH levels. EMD relapse/progression was correlated with EMD presentation at diagnosis, IgD subtype, and P53 deletion in FISH analysis, but not previous exposure to new drugs or transplantation. The presence of EMD involvement negatively affected survival. CI - Copyright (c) 2015 Elsevier Inc. All rights reserved. FAU - Deng, Shuhui AU - Deng S AD - State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College. FAU - Xu, Yan AU - Xu Y AD - State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College. FAU - An, Gang AU - An G AD - State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College. FAU - Sui, Weiwei AU - Sui W AD - State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College. FAU - Zou, Dehui AU - Zou D AD - State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College. FAU - Zhao, Yaozhong AU - Zhao Y AD - State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College. FAU - Qi, Junyuan AU - Qi J AD - State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College. FAU - Li, Fei AU - Li F AD - State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College. FAU - Hao, Mu AU - Hao M AD - State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College. FAU - Qiu, Lugui AU - Qiu L AD - State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College. Electronic address: drqiu99@medmail.com.cn. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20150103 PL - United States TA - Clin Lymphoma Myeloma Leuk JT - Clinical lymphoma, myeloma & leukemia JID - 101525386 RN - 0 (TP53 protein, human) RN - 0 (Tumor Suppressor Protein p53) SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Disease Progression MH - Female MH - Gene Frequency MH - Humans MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Multiple Myeloma/genetics/mortality/*pathology MH - Multivariate Analysis MH - Mutation MH - Prognosis MH - Proportional Hazards Models MH - Retrospective Studies MH - Treatment Outcome MH - Tumor Suppressor Protein p53/*genetics OTO - NOTNLM OT - Extramedullary disease OT - Multiple myeloma OT - P53 deletion OT - Prognosis EDAT- 2015/02/03 06:00 MHDA- 2016/01/28 06:00 CRDT- 2015/02/03 06:00 PHST- 2014/09/24 00:00 [received] PHST- 2014/12/24 00:00 [revised] PHST- 2014/12/29 00:00 [accepted] PHST- 2015/02/03 06:00 [entrez] PHST- 2015/02/03 06:00 [pubmed] PHST- 2016/01/28 06:00 [medline] AID - S2152-2650(14)00572-2 [pii] AID - 10.1016/j.clml.2014.12.013 [doi] PST - ppublish SO - Clin Lymphoma Myeloma Leuk. 2015 May;15(5):286-91. doi: 10.1016/j.clml.2014.12.013. Epub 2015 Jan 3.