Prognostic factors in multiple myeloma in a population‐based trial

Abstract

Prognostic factors have been tested in patients with multiple myeloma treated according to a randomized trial of standard therapy versus 5‐drug combination therapy. The following population‐based study included 92 patients with a median age of 70 yr. The median survival was 31 months. The Cox regression model was used to search for predictors of survival. The cut‐off levels for blood analyses derived in earlier studies tended to select few patients in the high‐risk groups, for example only 8% of the patients had hemoglobin (Hb) ≤ 7.5 g/dl. Lytic bone lesions in the pelvis or in the long bones, or spontaneous fractures and age > 70 yr gave prognostic information in addition to anemia and impaired renal function. The MRC staging system was a better prognostic tool than the Durie & Salmon stages. Palliative treatment regimens which take quality of life into account should be considered carefully in multiple myeloma patients > 70 yr.

Comparative analysis of the surgical treatment results for multiple myeloma bone disease of the spine and the long bone/soft tissue

“…A study including 84 MM patients who were surgically treated reported a recurrence rate of 6% (24). In the study by Hannisdal et al (25), the total local recurrence rate was 11.1%, which was similar to the recurrence rate of 6-22% reported in spinal metastases (37)(38)(39). In the current study, local recurrence was not reported in any of the 65 patients to date.…”

“…It can be assumed that plasma cells initially infiltrate the axial skeleton, leading to the compression of marrow. With increased cellular proliferation, extensive bone destruction, pathological fractures, hypercalcemia and osteolyses in long weight-bearing bones become evident, indicating an advanced stage of the disease (25). However, in our opinion, the surgery conducted on the spine is a larger invasive procedure compared with procedures on the long bone and soft tissue, which leads to a longer period of time before the patient is able to walk.…”

Surgical Management of Multiple Myeloma With Symptomatic Involvement of the Spine

“…Tumor recurrence in MM patients ranges between 6% and 11% in the literature. 54,61 We observed local tumor recurrences in 8% (2/24) within 1 year postoperatively. Both of them had received RT between 6 and 8 weeks after surgery, which is much later compared to an average of 3.3 weeks among those patients without recurrence.…”