Timing and Pattern of Extraosseous Dissemination Are Key Determinants of Survival in Multiple Myeloma - PubMed
3 days ago
- #Multiple Myeloma
- #Extraosseous Dissemination
- #Survival Prognosis
- Extraosseous (EO) involvement in multiple myeloma indicates systemic clonal escape and affects survival.
- The study of 543 patients used whole-body imaging to analyze EO disease as a time-varying covariate.
- EO disease was found in 24.6% of cases, with prognosis worsening based on timing and pattern: primary paraskeletal lesions (HR=2.22), secondary paraskeletal (HR=3.33), and secondary extramedullary disease (HR=8.14).
- Initial paraskeletal lesions increased the risk of evolving into secondary extramedullary disease by 2.6-fold.
- Prognostic factors for lower post-EO survival included secondary EMD, R2-ISS stage IV, number of treatment lines, and TP53 mutation.
- The adverse impact of EO disease persists even after adjusting for R2-ISS and cytogenetic status, highlighting the need to integrate timing and spatial features into risk frameworks.