Characterization of central nervous system multiple myeloma in the era of novel therapies

Majd, Nazanin; Wei, Xiao; Demopoulos, Alexis; Hormigo, Adı́lia; Chari, Ajai

doi:10.3109/10428194.2015.1122786

Cited by 12 publications

(20 citation statements)

References 13 publications

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“…A few other studies also reported deletion of chromosome 13q as the most frequent abnormality [13,26,[33][34][35][36]. One case series found that 8 of 9 patients had homozygous p53 deletion and 4 had 13q deletions.…”

Section: Cytogenetics and Molecular Geneticsmentioning

confidence: 98%

“…Upper cranial nerves (II-VII) or cranial nerves IX-XII (skull base) can be involved depending on the site of intracranial myeloma [23,24]. Visual blurring, ptosis, diplopia, and blindness also occur frequently in LMM, and orbital myeloma is one of the common presentations of MM with CNS involvement [25][26][27][28]. Of the cranial nerves, III, IV, and VI are probably the most commonly involved in intracranial myeloma, although involvement of other cranial nerves does occur.…”

Section: Cns Involvement Of MMmentioning

confidence: 99%

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Retracted: Overview of recent trends in diagnosis and management of leptomeningeal multiple myeloma

et al. 2014

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Neurological complications related to multiple myeloma (MM) are not uncommon; however, direct involvement of the central nervous system (CNS) is extremely rare and represents a diagnostic and therapeutic challenge. Significant survival difference has been noted with the introduction of novel therapy in patients with MM, but their effect on the incidence and their use for management of leptomeningeal myeloma (LMM) is uncertain. Analysis of published data demonstrates its recent increased incidence, median time to CNS presentation, and slight improvement in median survival after diagnosis of LMM. Less common MM isotypes have been overrepresented in LMM. CNS relapse occurred mostly in patients with Durie-Salmon stage III MM. Despite treatments, standard or experimental, the survival rates of LMM remain dismal. Monitoring high risk patients closely, even after achieving complete remission, may be useful in early detection of LMM. As we gain better understanding of LMM, we recommend that future research and clinical care focus on earlier diagnosis and development of more efficient CNS-directed therapy to improve survival in this patient population.

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Section: Cytogenetics and Molecular Geneticsmentioning

confidence: 98%

Section: Cns Involvement Of MMmentioning

confidence: 99%

Retracted: Overview of recent trends in diagnosis and management of leptomeningeal multiple myeloma

et al. 2014

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“…CSF protein is often increased while glucose is low on CNS-MM [7]. e recent use of abnormal free light chain detection on CSF is an attractive complementary diagnostic tool as it appears to be more reliable than cytology and could be used in patients with other equivocal test results and allowing therapy monitoring additionally [18][19][20]. e opposite is also possible, and patients have been described with intraparenchymal and dura lesions but with no plasma cells on CSF [17,21].…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the treatment of CNS-MM, significant data are sparse, and there is no standard of care advised for these cases [6,9,18]. Treatment of CNS-MM should include two essential approaches-be able to cross the BBB and treat the systemic disease.…”

Section: Discussionmentioning

confidence: 99%

“…e intrathecal agents are normally used in combination with systemic therapy that theoretically penetrates the BBB, and its use in monotherapy may be ineffective. Several reports show that patients that received ITC have a longer survival of 7.2 to 20 months versus 1.4 to 5 months for the patients who did not receive ITC [18,19]. In Case 2, with myelomatous meningitis, no systemic therapy was administrated due to the patient's bad performance status.…”

Section: Discussionmentioning

confidence: 99%

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Aggressive Central Nervous System Relapse after Autologous Stem Cell Transplant in Multiple Myeloma: Case Reports and Literature Review

Bergantim

Bastos

Soares

et al. 2020

Case Reports in Hematology

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Extramedullary disease is an aggressive presentation at diagnosis and relapse for multiple myeloma (MM) patients. Central nervous system (CNS) is a very rare manifestation of the extramedullary disease, accounting for less than 1% of MM on diagnosis and relapse. Neurological symptoms are unspecific and usually attributed to other causes. We present two patients with CNS-MM at relapse after autologous stem cell transplant highlighting the importance of clinical suspicion and interdisciplinarity at diagnostic workup as well as the need for intensive therapeutic options on such rare and aggressive cases. The presence of neurological abnormalities in anamnesis and physical examination on a patient with MM should always prompt to suspect of a CNS involvement, and active investigation must be undertaken. MRI is the standard radiological method to detect CNS-MM, with histopathological corroboration by stereotactic biopsy and CSF evaluation alongside. Treatment of CNS-MM should include two essential approaches—be able to cross the BBB and treat the systemic disease. There is no standard therapy for this extramedullary relapse, and a tailored and multiple therapy should be promptly started—intrathecal therapy, radiotherapy, and systemic therapy, including an immunomodulator.

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What the Intensivists Need to Know About Critically Ill Myeloma Patients

Nair¹,

Patel²

2018

Oncologic Critical Care

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Multiple myeloma (MM) is a hematological malignancy characterized by an increase in aberrant plasma cells in the bone marrow leading to rising monoclonal protein in serum and urine. With the introduction of novel therapies with manageable side effects, this incurable disease has evolved into a chronic disease with an acceptable quality of life for the majority of patients. Accordingly, management of acute complications is fundamental in reducing the morbidity and mortality in MM. MM emergencies include symptoms and signs related directly to the disease and/or to the treatment; many organs may be involved including, but not limited to, renal, cardiovascular, neurologic, hematologic, and infectious complications. This review will focus on the numerous approaches that are aimed at managing these complications.

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Characterization of central nervous system multiple myeloma in the era of novel therapies

Cited by 12 publications

References 13 publications

Retracted: Overview of recent trends in diagnosis and management of leptomeningeal multiple myeloma

Retracted: Overview of recent trends in diagnosis and management of leptomeningeal multiple myeloma

Aggressive Central Nervous System Relapse after Autologous Stem Cell Transplant in Multiple Myeloma: Case Reports and Literature Review

What the Intensivists Need to Know About Critically Ill Myeloma Patients

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