Multiple myeloma: an update

Kumar, Lalit; Nair, Sukesh C.; Vadlamani, Surya Prakash; Chaudhary, Priyanshu

doi:10.4103/jco.jco_43_20

Cited by 8 publications

(4 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Prior literature reviews of OMM by Lacy et al also surveyed English-language literature, and while they did not report race, none of the cases they reviewed were authored in India. Incidence of CMM in India remains low at 1.0 per 100,00 compared to 4.1 per 100,000 individuals in the West (15). Further research is needed to determine if this population has genetic factors that would classify them as a higher risk group or change treatment or prognosis.…”

Section: History and Demographicsmentioning

confidence: 99%

Non-secretory Multiple Myeloma Associated with Diffuse Osteosclerotic Bone Lesions: A Case Report and Review of Cases since 1997

Veeramachaneni

DeBevits

Anderson³

et al. 2023

Preprint

View full text Add to dashboard Cite

Background: Multiple myeloma is the second most common hematologic malignancy typically involving monoclonal immunoglobulin secretion by malignant plasma cells and lytic bone lesions. Sclerotic lesions appear in 3% of cases, and only 1-3% of multiple myeloma patients produce no detectable paraprotein. This case involves a challenging diagnosis of a rare presentation of both non-secretory and osteosclerotic multiple myeloma. Case Presentation: A 59-year-old woman with prior history of breast cancer presented with 2 months of back pain and was found to have T1 and T11 sclerotic lesions on imaging. Positron emission tomography (PET) revealed additional L4 sclerotic lesions and right manubrium as well as a single lytic lesion of the right ilium. Biopsy revealed 40% plasma cell infiltrate producing monoclonal lambda light chains. Protein electrophoresis was normal. The patient was absent of POEMS Syndrome features. The patient was diagnosed with osteosclerotic multiple myeloma (OMM) and initiated on chemotherapy and received an autologous stem cell transplant. Repeat PET demonstrated stabilization of sclerotic lesions and decreased metabolic activity of the lytic lesion. She is currently on maintenance Revlimid. Conclusions: OMM is an extremely rare subtype of classical multiple myeloma (CMM), with less than 50 cases reported prior to 1997. This paper presents the most comprehensive current review of OMM since. OMM presents in younger patients with no sex preference most commonly with back pain, dyspnea, and weakness/fatigue. 29% of patients reviewed were South Asian, warranting further research into risk factors for this population. Hypercalcemia is rare in OMM, while renal insufficiency and anemia are more common than in CMM. OMM has median infiltrate of 45% with even distribution of kappa and lambda chain monoclonal gammopathy. It most commonly involves the vertebrae but has greater involvement in the pelvis and long bones than CMM. OMM is more indolent with better survival. Our case represented a challenging diagnosis with normal typical laboratory markers of MM and unremarkable findings on SPEP given that the OMM also was non-secretory. Although rare, OMM should be considered in diagnosis of patients with persistent back pain despite 1-2 months of conventional conservative treatment using computed tomography or magnetic resonance imaging.

show abstract

Section: History and Demographicsmentioning

confidence: 99%

Non-secretory Multiple Myeloma Associated with Diffuse Osteosclerotic Bone Lesions: A Case Report and Review of Cases since 1997

Veeramachaneni

DeBevits

Anderson³

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…The 2-and 5-year PFS were 60 and 18%, respectively (►Fig. 1). The OS at 2 and 5 years were 80 and 53%, respectively (►Fig.…”

Section: Treatment Received and Outcomementioning

confidence: 99%

“…The incidence of MM in India is lower when compared with the West (1/1,00,000 vs 4.1/1,00,000), but, as per recent statistics, the numbers are expanding. 1 As the life expectancy of the general population is on the rise, the proportion of elderly patients with various malignancies is expected to rise as well. MM deserves special mention in this seam, as the majority affected are elderly, frail, and transplant ineligible.…”

Section: Introductionmentioning

confidence: 99%

“…The median survival of elderly patients with MM has improved in recent years with the advent of newer agents, starting from bortezomib in late 2000s. 1 In 1990s, combination of melphalan, prednisone, and thalidomide was considered as a standard of care in elderly MM, who were transplant ineligible. 1 Present study looked at the role of lenalidomide along with melphalan and prednisone, herein after referred as MPL-L (melphalan-prednisone-lenalidomide induction followed by lenalidomide maintenance) in elderly patients as front-line therapy in MM.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Prospective Single-Arm Study of Melphalan, Prednisolone and Lenalidomide (MPL) as First Line Treatment in Elderly Patients with Multiple Myeloma – An Institutional Study

Lakshmi

Narayanan

Abdul

et al. 2022

Indian J Med Paediatr Oncol

View full text Add to dashboard Cite

Introduction Multiple myeloma in the elderly population is rising in India. Such frail transplant-ineligible patients are less frequently included in clinical trials. Moreover, novel agents are not accessible to everyone. Melphalan-based chemotherapy regimens are frequently used in elderly myeloma patients. Our study revisited the role of melphalan, prednisone, and lenalidomide (MPL) as front-line therapy in this subgroup of patients. Objective The aim of this study was to determine the response, tolerance, and outcome of MPL in elderly patients with newly diagnosed multiple myeloma. Materials and Methods This prospective study was conducted at the Department of Medical Oncology at a tertiary cancer center during January 2012 to September 2013. Newly diagnosed patients with multiple myeloma >60 years who were transplant ineligible formed the study subjects. Eligible patients received oral melphalan 0.18 mg/kg from D1 to 4, prednisone 2 mg/kg from D1 to 4, and lenalidomide 10 mg from D1 to 21 q28 days. Patients who achieved complete response/very good partial response (CR/VGPR) after 6 cycles of MPL received maintenance with lenalidomide 10 mg from D1 to 21 q28 days (MPL-L) until progression or 1 year whichever was earlier. Quality of life was assessed using the Eq. 5D questionnaire. Results Out of 46 patients, 25 were males and 21 were females. Median age was 67 years (range: 60—83 years). Majority had immunoglobulin G myeloma, followed by immunoglobulin A subtype. The median quality of life score at baseline was 50 (range: 30–70). Forty patients completed six cycles of MPL. The main toxicity was grade 1 to 2 hematological. There were no treatment-related deaths. Twenty-two (55%) achieved CR, 5 (13%) achieved VGPR, 4 (10%) achieved partial response, 6 (15%) achieved stable disease, and 3 (7%) had progressive disease. Twenty-seven patients received lenalidomide maintenance. At a median follow-up of 55 months, the 2- and 5-year progression-free survival was 60 and 18%, respectively. The overall survival at 2 and 5 years were 80 and 53%, respectively. The median number of subsequent lines of treatment was 2 (range: 1–4). The quality of life was improved and preserved in all study subjects. At 8 years, three patients had second malignant neoplasms and seven are alive. Conclusion MPL-L is a well-tolerated and effective regimen in elderly myeloma with good overall response rates.

show abstract

Documentation of International Staging System (ISS) and Revised International Staging System (R-ISS) for Multiple Myeloma at a Tertiary Care Center: A Clinical Audit

Girija Sivasankaran,

Edachalil Veeraraghavan,

Sidharthan

2023

Ind J Clin Biochem

View full text Add to dashboard Cite

Multiple myeloma: an update

Cited by 8 publications

References 26 publications

Non-secretory Multiple Myeloma Associated with Diffuse Osteosclerotic Bone Lesions: A Case Report and Review of Cases since 1997

Non-secretory Multiple Myeloma Associated with Diffuse Osteosclerotic Bone Lesions: A Case Report and Review of Cases since 1997

A Prospective Single-Arm Study of Melphalan, Prednisolone and Lenalidomide (MPL) as First Line Treatment in Elderly Patients with Multiple Myeloma – An Institutional Study

Documentation of International Staging System (ISS) and Revised International Staging System (R-ISS) for Multiple Myeloma at a Tertiary Care Center: A Clinical Audit

Contact Info

Product

Resources

About