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Abstract:
:Here, we report the outcome of 226 myeloma patients presenting with extramedullary plasmacytoma or paraosseous involvement in a retrospective study conducted in 19 centers from 11 countries. Extramedullary disease was detected at diagnosis or relapse between January 2010 and November 2017. Extramedullary plasmacytoma and paraosseous involvement were observed in 130 patients at diagnosis (92 of 38) and in 96 at relapse (84 of 12). The median time from multiple myeloma diagnosis to the development of extramedullary disease was 25.1 months (range 3.1-106.3 months) in the relapse group (median follow up: 15 months). Imaging approach for extramedullary disease was computed tomography (n=133), positron emission tomography combined with computed tomography (n=50), or magnetic resonance imaging (n=35). The entire group received a median two lines of treatment and autologous stem cell transplantation (44%) following the diagnosis of extramedullary disease. Complete response was higher for paraosseous involvement versus extramedullary plasmacytoma at diagnosis (34.2% vs 19.3%; P=NS.) and relapse (54.5% vs 9%; P=0.001). Also paraosseous involvement patients had a better progression-free survival (PFS) when recognized at initial diagnosis of myeloma than at relapse (51.7 vs 38.9 months). In addition, overall survival was better for paraosseous involvement compared to extramedullary plasmacytoma at diagnosis (not reached vs 46.5 months). Extramedullary plasmacytoma at relapse had the worst prognosis with a PFS of 13.6 months and overall survival of 11.4 months. In the multivariate analysis, paraosseous involvement, extramedullary disease at diagnosis, International Staging System (ISS-I), and undergoing autologous stem cell transplantation improved overall survival independently. This cohort demonstrated that extramedullary disease benefits from front-line autologous stem cell transplantation and extramedullary plasmacytoma differs from paraosseous involvement in terms of rate and duration of response, with even worse outcomes when detected at relapse, constituting an unmet clinical need.
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最新影响因子:11.047 | 期刊ISSN:0390-6078 | CiteScore:4.28 |
出版周期: | 是否OA:YES | 出版年份:0 |
期刊官方网址:http://haematologica.org/
自引率:4.00% | 研究方向:HEMATOLOGY- |
出版地区:ITALY |
SCI期刊coverage:Science Citation Index Expanded(科学引文索引扩展)
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Published by Ferrata Storti Foundation. ISSN: 0390-6078.
由Ferrata Storti基金会出版。ISSN: 0390 - 6078。
大类(学科) | 小类(学科) | 学科排名 |
医学 |
HEMATOLOGY (血液学) 2区 |
5/71 |
年度总发文量 | 年度论文发表量 | 年度综述发表量 |
239 | 225 | 14 |
引文计数(2018)
文献(2015-2017)
4418次引用
1032篇文献
序号 | 类别 | 排名 | 百分位 |
1 |
大类(学科):Medicine
小类(学科):Hematology
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#9/120
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研究方向:凝血
接受率: 比较困难(25%命中)
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研究方向:医药科学 血液系统
审稿时间: 2个月内
影响因子:2.566
ISSN:0739-7240
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影响因子:1.297
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研究方向:医学-精神病学
影响因子:4.604
ISSN:1092-8529
研究方向:医学-精神病学
影响因子:5.345
ISSN:1398-5647
研究方向:医学-精神病学
影响因子:3.492
ISSN:1540-2002
研究方向:CLINICAL NEUROLOGY-PSYCHIATRY
影响因子:4.562
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研究方向:医学-精神病学
影响因子:6.533
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研究方向:医学-精神病学
影响因子:5.415
ISSN:0924-977X
研究方向:医学-精神病学
发表一篇学和医学成像类SCI论文
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