Ten‐year survival and prognostic factors in multiple myeloma

Tsuchiya, Jun; Murakami, Hirokazu; Kanoh, Tadashi; Kosaka, Masaaki; Sezaki, T; Mikuni, Chikara; Kawato, Masafumi; Takagi, Toshiyuki; Togawa, Atsushi; Isobe, Takashi; Suzuki, Kenshi; Imamura, Yukio; Takatsuki, Kiyoshi

doi:10.1111/j.1365-2141.1994.tb06745.x

Cited by 33 publications

(26 citation statements)

References 9 publications

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“…The literature, however, is by no means devoid of instances of 10-year survival following conventional chemotherapy [11][12][13][14][15][16][17]. This points to the existence of a possibly "low-risk" subset of patients whose unexpectedly long survival is due to largely unknown reasons.…”

Section: Introductionmentioning

confidence: 86%

Long-term survival in multiple myeloma: a single-center experience

2008

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In patients with multiple myeloma the median overall survival is now approaching 5 years, following the introduction of autologous stem cell transplantation and targeted therapies. However, patients receiving conventional chemotherapy who have survived 10 years or longer have been repeatedly reported in the literature. From 723 patients with multiple myeloma seen in our department from January 1981 to June 2007, we selected 21 long-term (> or =10 years) survivors (2.9%) who had been treated with conventional chemotherapy. Potentially favourable prognostic factors, common to most patients, were: age < or =65 years; response to first-line chemotherapy; absence of Bence-Jones proteinuria; prolonged duration of response or stable disease irrespective of the primary regimen; maintenance therapy with interferon-alpha. The use of prognostic factors to identify a subset of low-risk patients could be of assistance in the selection of targeted treatments and the elucidation of poorly known features of myeloma biology.

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Section: Introductionmentioning

confidence: 86%

Long-term survival in multiple myeloma: a single-center experience

2008

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“…PC of these patients were divided into 4 subtypes (mature, intermediate, immature and plasmoblasts). The most extensive clinical study from that time period is the Japanese study of 1119 patients published in 1994 [8]. Patients who survived for more than 10 years had more mature plasmocytes in BM biopsies when compared to patients with shorter survival (54% vs. 31%; p= 0,01).…”

Section: Discussionmentioning

confidence: 99%

“…Overall survival (OS) was found to be 54 months for patients with plasmoblasts < 2% in comparison to 20 months for patients with plasmoblasts ≥ 2% [5]. In the largest morphological study conducted in Japan on 1119 patients, the presence of more mature plasmocytes also showed better prognosis [8].…”

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confidence: 99%

Prognostic significance of morphological assessment of plasma cells in multiple myeloma

Al-Sahmani

Trnavská²,

Ševčı́ková³

et al. 2011

neo

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Multiple myeloma (MM) is a hematological malignancy caused by clonal proliferation of malignant plasma cells (PC).The aim of the work is to determine prognostic significance of morphological subtypes of PC in relation to overall treatment response, long-term survival and other conventional prognostic parameters. One hundred and thirty-nine newly diagnosed MM patients who underwent autologous transplantation in clinical trials conducted in one center were included. Percentual representation of subtypes of plasma cells in bone marrow was measured based on progressive analysis of nucleolus, nuclear chromatin and ratio of nuclei to the volume of cytoplasm (N/C ratio) creating 8 subtypes P000-P111 and four subclassifications of cells. Mature plasma cells (P000, P001) were found in 42.4% of patients; proplasmocytes I (P010, P011, P100) in 38.1% of patients, and proplasmocytes II (P101, P110) in 19.4% of patients. Patients who reached treatment response after autologous transplantation had statistically significant lower frequency of mature plasma cells than patients with no treatment response (median 24.0% vs. 36.0 %; p=0.032). Patients with mature plasma cells of subtype P000 < 10% had significantly shorter overall survival than patients with value P000 ≥ 37% (median 46.8 months vs. 77.8 months; p = 0.020). Patients with proplasmocytes II subtype P110 < 3% had longer time to progression than patients with subtype P110 ≥ 31% (median 54.6 months vs. 22.4 months; p=0.045). Our work brings valuable prognostic information and correlation with other prognostic factors as well as total treatment response and survival in MM patients who underwent autologous transplantation.

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“…As a few previously reported cases of multiple myeloma with prolonged disease-free survival, this patient has been in CR for more than 10 years, and her disease condition represents ‘a cure’ or ‘a state extremely close to cure’ [14, 15, 16, 17]. Many investigators have suggested prognostic factors of multiple myeloma [5, 6, 9, 18]. This patient had some favorable prognostic factors: a relatively young age, a normal platelet count and normal serum creatinine, serum calcium, serum β 2 -M and CRP levels, a favorable M-protein type and a favorable morphological type of myeloma [18].…”

Section: Discussionmentioning

confidence: 99%

“…However, despite these therapies, few cases have been considered to be cured [3]. Conventional chemotherapy has led to prolonged survival (over 10 years) in only about 2–4% of patients, with many of these patients exhibiting signs suggesting the presence of tumors, and very few cases in which an uneventful cure is expected [5, 6, 7]. …”

Section: Introductionmentioning

confidence: 99%

Ten-Year Survivor with Multiple Myeloma in First Complete Remission following Treatment with Conventional Chemotherapy

Abe

Ishibashi²,

Shichishima³

et al. 2001

Acta Haematol

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A 62-year-old woman with multiple myeloma, who has been in complete remission (CR) for 10 years, is reported. The patient was treated with conventional chemotherapy, including nitrosourea derivatives. Five patients with myeloma, including the present case, who have survived for 10 years or more in CR and on whom detailed clinical descriptions were published, are reviewed. Their disease condition represented ‘a cure’ or ‘a state extremely close to cure’. The review indicates the following favorable prognostic factors common to these patients: age ≤65 years and a rapid response to treatment. Progressive bone destruction and/or lytic changes at disease onset is perhaps not a bad prognostic factor in myeloma patients with excellent outcome.

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Ten‐year survival and prognostic factors in multiple myeloma

Cited by 33 publications

References 9 publications

Long-term survival in multiple myeloma: a single-center experience

Long-term survival in multiple myeloma: a single-center experience

Prognostic significance of morphological assessment of plasma cells in multiple myeloma

Ten-Year Survivor with Multiple Myeloma in First Complete Remission following Treatment with Conventional Chemotherapy

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