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

Yellu, Mahender; Engel, Jessica M.; Ghose, Abhimanyu; Onitilo, Adedayo A.

doi:10.1002/hon.2185

Cited by 16 publications

(27 citation statements)

References 46 publications

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“…This dismal prognosis may have been caused by the fact that most of the drugs used in myeloma do not penetrate the blood-brain barrier if used for systemic treatment [15]. Newer drugs such as carfilzomib, marizomib, and pomalidomide may penetrate the blood-brain barrier and so may be used as therapeutic options in such situations [5,[16][17][18]. We observed 1 long-term survivor with LMM (patient No.…”

Section: Discussionmentioning

confidence: 87%

Leptomeningeal Myelomatosis: A Rare but Devastating Manifestation of Multiple Myeloma Diagnosed Using Cytology, Flow Cytometry, and Fluorescent in situ Hybridization

et al. 2018

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Introduction: Involvement of the central nervous system in patients with multiple myeloma is a rare event. We evaluated the diagnostic workup and prognosis of patients with leptomeningeal myelomatosis (LMM). Methods: Between April 2005 and April 2016, we identified 16 cases with LMM. The involvement was diagnosed by magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) cytology as well as flow cytometry. Fluorescence in situ hybridization (FISH) was used in 8/16 cases. In 1 case, genome-wide screening for genetic alterations using single-nucleotide polymorphism (SNP) array analysis was performed. Results: The median time from initial diagnosis until the occurrence of LMM was 434 days. At diagnosis, the median age was 60 years. The median cell count was 21/µL (range 1–1,333/µL). All CSF samples showed malignant pleocytosis, confirmed by flow cytometry in 12/16 patients. FISH revealed high-risk features in the majority of samples. Treatment for LMM consisted of intrathecal chemotherapy and radiation therapy. Genome-wide screening assays revealed different subclones. The outcome was dismal with a median overall survival after the diagnosis of LMM of 82 days. Conclusion: By combining several technical procedures, it is possible to identify most patients with LMM. Management of affected patients is challenging and the survival short after a diagnosis of LMM.

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Section: Discussionmentioning

confidence: 87%

Leptomeningeal Myelomatosis: A Rare but Devastating Manifestation of Multiple Myeloma Diagnosed Using Cytology, Flow Cytometry, and Fluorescent in situ Hybridization

et al. 2018

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“…Tomografia komputerowa jest mało czuła w zakresie wykrywania zmian szpiczakowych w OUN. Do ich obrazowania z wyboru stosuje się MRI z gadolinem [14][15][16]. U około 10% chorych z zajęciem OUN jednak badanie to może być ujemne [6].…”

Section: Diagnostykaunclassified

“…Petersen [19] przedstawił tezę o krążących komórkach progenitorowych dla plazmocytów, które miałyby być źródłem przerzutów. W części publikowanych analiz zauważono nadreprezentację rzadkich typów szpiczaka, jak IgA 28-30% i IgD 3-12% oraz postaci biklonalnej 3-5% [6,16,19]. Udowodniono już, że niekorzystny profil cytogenetyczny jest związany z gorszym rokowaniem i bardziej agresywnym przebiegiem szpiczaka.…”

Section: Etiologia I Czynniki Ryzykaunclassified

“…Fassas [13] u 14 z 25 chorych stwierdził del13q, u 7 zaś zaburzenia w obrębie chromosomu 11. W niektórych pracach wiązano wysoki LDH z większym ryzykiem zajęcia OUN [16], ale nie wszyscy autorzy to potwierdzają [6]. Trwają dyskusje nad znaczeniem ekspresji CD56 -molekuły adhezyjnej, na plazmocytach w tworzeniu nacieków w tkankach miękkich.…”

Section: Etiologia I Czynniki Ryzykaunclassified

“…Uważa się, że uwrażli-wia tkanki na działanie radioterapii. Jednak jego aktywność w szpiczaku wydaje się być ograniczona [16,28]. Temozolomid, który przekracza barierę krew-mózg, również bywa stosowany w polichemioterapii.…”

Section: Leczenieunclassified

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Zajęcie ośrodkowego układu nerwowego w przebiegu szpiczaka plazmocytowego – opis przypadku i przegląd literatury

Jurczyszyn¹,

Olszewska-Szopa²,

Fornagiel³

et al. 2015

Acta Haematologica Polonica

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a c t a h a e m a t o l o g i c a p o l o n i c a 4 6 ( 2 0 1 5 ) 2 4 2 -2 4 7 i n f o r m a c j e o a r t y k u l e Historia artykułu: Słowa kluczowe: szpiczak ośrodkowy układ nerwowy diagnostyka leczenie Słowa kluczowe: Myeloma Central nervous system Diagnosis Treatment a b s t r a c t In multiple myeloma extramedullary involvement occurs in 13% of patients. Central nervous system (CNS) involvement is extremely rare and comprises 1% of cases. Review of literature shows only limited data on this subject and consists mostly of few case reports. Scarce knowledge about CNS involvement in the course of multiple myeloma makes its diagnosis and treatment very difficult and challenging. The authors describe a clinical case which illustrates the problem from a clinician point of view. Furthermore, we analyzed the available data from literature and summarized the current state of knowledge on diagnosis, potential prognostic factors, treatment and prognosis in CNS myeloma involvement.

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Central nervous system involvement by multiple myeloma: A multi‐institutional retrospective study of 172 patients in daily clinical practice

et al. 2016

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The multicenter retrospective study conducted in 38 centers from 20 countries including 172 adult patients with CNS MM aimed to describe the clinical and pathological characteristics and outcomes of patients with multiple myeloma (MM) involving the central nervous system (CNS). Univariate and multivariate analyses were performed to identify prognostic factors for survival. The median time from MM diagnosis to CNS MM diagnosis was 3 years. Thirty-eight patients (22%) were diagnosed with CNS involvement at the time of initial MM diagnosis and 134 (78%) at relapse/progression. Upon diagnosis of CNS MM, 97% patients received initial therapy for CNS disease, of which 76% received systemic therapy, 36% radiotherapy and 32% intrathecal therapy. After a median follow-up of 3.5 years, the median overall survival (OS) from the onset of CNS involvement for the entire group was 7 months. Untreated and treated patients had median OS of 2 and 8 months, respectively (p<0.001). At least one previous line of therapy for MM before the diagnosis of CNS disease and >1 cytogenetic abnormality detected by FISH were independently associated with worse OS. The median OS for patients with 0, 1 and 2 of these risk factors were 25 months, 5.5 months and 2 months, respectively (p<0.001). Neurological manifestations, not considered chemotherapy-related, observed at any time after initial diagnosis of MM should raise a suspicion of CNS involvement. Although prognosis is generally poor, the survival of previously untreated patients and patients with favorable cytogenetic profile might be prolonged due to systemic treatment and/or radiotherapy.

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

Cited by 16 publications

References 46 publications

Leptomeningeal Myelomatosis: A Rare but Devastating Manifestation of Multiple Myeloma Diagnosed Using Cytology, Flow Cytometry, and Fluorescent in situ Hybridization

Leptomeningeal Myelomatosis: A Rare but Devastating Manifestation of Multiple Myeloma Diagnosed Using Cytology, Flow Cytometry, and Fluorescent in situ Hybridization

Zajęcie ośrodkowego układu nerwowego w przebiegu szpiczaka plazmocytowego – opis przypadku i przegląd literatury

Central nervous system involvement by multiple myeloma: A multi‐institutional retrospective study of 172 patients in daily clinical practice

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