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. 2010 Mar 20;28(9):1606-10.
doi: 10.1200/JCO.2009.25.5356. Epub 2010 Feb 22.

Prognostic significance of focal lesions in whole-body magnetic resonance imaging in patients with asymptomatic multiple myeloma

Jens Hillengass  1 , Kerstin Fechtner, Marc-André Weber, Tobias Bäuerle, Sofia Ayyaz, Christiane Heiss, Thomas Hielscher, Thomas M Moehler, Gerlinde Egerer, Kai Neben, Anthony D Ho, Hans-Ulrich Kauczor, Stefan Delorme, Hartmut Goldschmidt
Affiliations

Prognostic significance of focal lesions in whole-body magnetic resonance imaging in patients with asymptomatic multiple myeloma

Jens Hillengass et al. J Clin Oncol. .

Abstract

Purpose: With whole-body magnetic resonance imaging (wb-MRI), almost the whole bone marrow compartment can be examined in patients with monoclonal plasma cell disease. Focal lesions (FLs) detected by spinal MRI have been of prognostic significance in symptomatic multiple myeloma (sMM). In this study, we investigated the prognostic significance of FLs in wb-MRI in patients with asymptomatic multiple myeloma (aMM).

Patients and methods: Wb-MRI was performed in 149 patients with aMM. The prognostic significance of the presence and absence, as well as the number, of FLs for progression into sMM was analyzed.

Results: FLs were present in 28% of patients. The presence per se of FLs and a number of greater than one FL were the strongest adverse prognostic factors for progression into sMM (P < .001) in multivariate analysis. A diffuse infiltration pattern in MRI, a monoclonal protein of 40 g/L or greater, and a plasma cell infiltration in bone marrow of 20% or greater were other adverse prognostic factors for progression-free survival in univariate analysis.

Conclusion: We recommend use of wb-MRI for risk stratification of patients with asymptomatic multiple myeloma.

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