Clinical impact of spine magnetic resonance imaging as a valuable prognostic tool for patients with multiple myeloma: a retrospective study
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: This study investigated the prognostic impact of spine magnetic resonance imaging (MRI) in patients newly diagnosed with multiple myeloma (MM). Methods: We retrospectively evaluated 214 patients who were newly diagnosed with MM between March 2015 and December 2019. The patients were classified into five different infiltration patterns based on spine MRI as follows: (1) normal appearance, (2) focal, (3) diffuse, (4) combined focal and diffuse infiltration, and (5) “salt-and-pepper.” Results: Forty patients (18.7%) showed a normal appearance, whereas focal, diffuse, combined focal and diffuse infiltration, and “salt-and-pepper” patterns were identified in 68 (31.8%), 40 (18.7%), 52 (24.3%), and 14 patients (6.5%), respectively. The patients with normal and “salt-and-pepper” patterns were younger than patients with other patterns (median age, 61.6 vs. 66.8 years; p=0.001). Moreover, 63% and 59.3% of patients with normal and “salt-and-pepper” patterns were scored International Staging System (ISS) stage I and revised ISS (R-ISS) stage I, respectively, whereas only 12.5% of patients with other patterns were scored ISS stage I and R-ISS stage I. Patients with normal and “salt-and-pepper” patterns had a better prognosis than those with other patterns, whereas relapse and death rates were significantly higher in patients with focal, diffuse, and combined MRI patterns. Conclusion: Characteristic MRI findings have a significant prognostic value for long-term survival in patients newly diagnosed with MM. In particular, focal, diffuse, and combined focal and diffuse infiltration patterns are unfavorable prognostic factors.
Abstract
Background: This study investigated the prognostic impact of spine magnetic resonance imaging (MRI) in patients newly diagnosed with multiple myeloma (MM). Methods: We retrospectively evaluated 214 patients who were newly diagnosed with MM between March 2015 and December 2019. The patients were classified into five different infiltration patterns based on spine MRI as follows: (1) normal appearance, (2) focal, (3) diffuse, (4) combined focal and diffuse infiltration, and (5) “salt-and-pepper.” Results: Forty patients (18.7%) showed a normal appearance, whereas focal, diffuse, combined focal and diffuse infiltration, and “salt-and-pepper” patterns were identified in 68 (31.8%), 40 (18.7%), 52 (24.3%), and 14 patients (6.5%), respectively. The patients with normal and “salt-and-pepper” patterns were younger than patients with other patterns (median age, 61.6 vs. 66.8 years; p=0.001). Moreover, 63% and 59.3% of patients with normal and “salt-and-pepper” patterns were scored International Staging System (ISS) stage I and revised ISS (R-ISS) stage I, respectively, whereas only 12.5% of patients with other patterns were scored ISS stage I and R-ISS stage I. Patients with normal and “salt-and-pepper” patterns had a better prognosis than those with other patterns, whereas relapse and death rates were significantly higher in patients with focal, diffuse, and combined MRI patterns. Conclusion: Characteristic MRI findings have a significant prognostic value for long-term survival in patients newly diagnosed with MM. In particular, focal, diffuse, and combined focal and diffuse infiltration patterns are unfavorable prognostic factors.
참고문헌 (31)
- Siegel RL, "Cancer statistics, 2020", CA Cancer J Clin, 70, pp.7~30 (2020)
- Cavo M, "Bortezomib with thalidomide plus dexamethasone compared with thalidomide plus dexamethasone as induction therapy before, and consolidation therapy after, double autologous stem-cell transplantation in newly diagnosed multiple myeloma : a randomised phase 3 study", Lancet, 376, pp.2075~2085 (2010)
- Richardson PG, "Lenalidomide, bortezomib, and dexamethasone combination therapy in patients with newly diagnosed multiple myeloma", Blood, 116, pp.679~686 (2010)
- Cardona-Benavides IJ, "Genetic abnormalities in multiple myeloma : prognostic and therapeutic implications", Cells, 10, pp.336~ (2021)
- Usmani SZ, "Clinical predictors of long-term survival in newly diagnosed transplant eligible multiple myeloma : an IMWG Research Project", Blood Cancer J, 8, pp.123~ (2018)
- Dimopoulos MA, "The International Scoring System(ISS)for multiple myeloma remains a robust prognostic tool independently of patients’ renal function", Ann Oncol, 23, pp.722~729 (2012)
- Palumbo A, "Revised international staging system for multiple myeloma : a report from International Myeloma Working Group", J Clin Oncol, 33, pp.2863~2869 (2015)
- Rajkumar SV, "International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma", Lancet Oncol, 15, pp.e538~e548 (2014)
- Walker R, "Magnetic resonance imaging in multiple myeloma : diagnostic and clinical implications", J Clin Oncol, 25, pp.1121~1128 (2007)
- Bäuerle T, "Multiple myeloma and monoclonal gammopathy of undetermined significance : importance of whole-body versus spinal MR imaging", Radiology, 252, pp.477~485 (2009)
- Ailawadhi S, "Extent of disease burden determined with magnetic resonance imaging of the bone marrow is predictive of survival outcome in patients with multiple myeloma", Cancer, 116, pp.84~92 (2010)
- Moulopoulos LA, "Diffuse MRI marrow pattern correlates with increased angiogenesis, advanced disease features and poor prognosis in newly diagnosed myeloma treated with novel agents", Leukemia, 24, pp.1206~1212 (2010)
- Moulopoulos LA, "Prognostic significance of magnetic resonance imaging of bone marrow in previously untreated patients with multiple myeloma", Ann Oncol, 16, pp.1824~1828 (2005)
- 송익찬, "Diagnostic and Prognostic Implications of Spine Magnetic Resonance Imaging at Diagnosis in Patients with Multiple Myeloma", Cancer Research and Treatment, 47(3), pp.465~472 (2015), 대한암학회[DOI]
- Dutoit JC, "MRI in multiple myeloma : a pictorial review of diagnostic and post-treatment findings", Insights Imaging, 7, pp.553~569 (2016)
- Narquin S, "Comparison of whole-body diffusion MRI and conventional radiological assessment in the staging of myeloma", Diagn Interv Imaging, 94, pp.629~636 (2013)
- Terpos E, "International Myeloma Working Group recommendations for the treatment of multiple myeloma-related bone disease", J Clin Oncol, 31, pp.2347~2357 (2013)
- Xiao W, "Cellular and molecular aspects of bone remodeling", Front Oral Biol, 18, pp.9~16 (2016)
- Nakashima T, "Evidence for osteocyte regulation of bone homeostasis through RANKL expression", Nat Med, 17, pp.1231~1234 (2011)
- Delgado-Calle J, "Bidirectional notch signaling and osteocyte-derived factors in the bone marrow microenvironment promote tumor cell proliferation and bone destruction in multiple myeloma", Cancer Res, 76, pp.1089~1100 (2016)
- Hanrahan CJ, "Current concepts in the evaluation of multiple myeloma with MR imaging and FDG PET", CT, 2010, pp.30, 127~142
- Kusumoto S, "Magnetic resonance imaging patterns in patients with multiple myeloma", Br J Haematol, 99, pp.649~655 (1997)
- Dimopoulos M, "International myeloma working group consensus statement and guidelines regarding the current role of imaging techniques in the diagnosis and monitoring of multiple myeloma", Leukemia, 23, pp.1545~1556 (2009)
- Zamagni E, "A prospective comparison of 18F-fluorodeoxyglucose positron emission tomography-computed tomography, magnetic resonance imaging and whole-body planar radiographs in the assessment of bone disease in newly diagnosed multiple myeloma", Haematologica, 92, pp.50~55 (2007)
- Delorme S, "Imaging in multiple myeloma", Recent Results Cancer Res, 183, pp.133~147 (2011)
- Baur-Melnyk A, "Whole-body MRI versus whole-body MDCT for staging of multiple myeloma", AJR Am J Roentgenol, 190, pp.1097~1104 (2008)
- Moulopoulos LA, "Diffuse pattern of bone marrow involvement on magnetic resonance imaging is associated with high risk cytogenetics and poor outcome in newly diagnosed, symptomatic patients with multiple myeloma : a single center experience on 228 patients", Am J Hematol, 87, pp.861~864 (2012)
- Hillengass J, "Gain of 1q21 and distinct adverse cytogenetic abnormalities correlate with increased microcirculation in multiple myeloma", Int J Cancer, 122, pp.2871~2875 (2008)
- Attal M, "A prospective, randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma. Intergroupe Français du Myélome", N Engl J Med, 335, pp.91~97 (1996)
- Child JA, "High-dose chemotherapy with hematopoietic stem-cell rescue for multiple myeloma", N Engl J Med, 348, pp.1875~1883 (2003)
- Koreth J, "High-dose therapy with single autologous transplantation versus chemotherapy for newly diagnosed multiple myeloma : a systematic review and meta-analysis of randomized controlled trials", Biol Blood Marrow Transplant, 13, pp.183~196 (2007)