Clinical Analysis Of26Cases Of Multiple Myeloma Complicated By Extrameduilary Plasmacytomas

Objective:To explore the clinical features,treatments and prognosis of multiplemyeloma (MM) with extramedullary plasmacytomas (EM) at firstdiagnosis．Methods:We retrospectively analyzed the clinical data of267cases of patientswith MM from January2010to December2014,26with EM at diagnosis(Group A),241without EM (Group B).Explored the clinical features ofmultiple myeloma (MM) with extramedullary plasmacytomas (EM) atfirst diagnosis respectively and according to whether containingbortezomib in its treatment,we compared the overall reaction rate andmedian survival time.Results:The incidence of EM at diagnosis was9.7%(26/267). The commonlocations of EM were soft tissue (11/26), pleura (7/26) and spinal canal(5/26),and the uncommon locations including liver, lymphnode and eyes(each1case). The common clinical types of EM were lightchain,38.5%(10/26).There was no significant difference in plasmablasts in bone marrow and FISH genetic testing of patients between A and Bgroup (P＞0.05). Till December,2014, we follow-up visited205patients,the median follow-up time was12(0.5-57) months,26with EM atdiagnosis (Group A),182without EM (Group B). Among all patients,107received combined treatment including bortezomib, and101underwenttraditional chemotherapy, the overall response rate(ORR) of the patientsreceived combined treatment including bortezomib and underwenttraditional chemotherapy was73.8%vs42.6%(P＜0.001);the medianoverall survival (OS) of the patients received combined treatmentincluding bortezomib and underwent traditional chemotherapy was16.5(months) vs10(months)(P=0.017). Fourteen patients received combinedtreatment of bortezomib and11underwent traditional chemotherapy ofGroup A, the ORR and OS were60.0%(9/15) vs27.3%(3/11)(P=0.098)9(months) vs6(months)(P=0.54),respectively;92patients receivedcombined treatment of bortezomib,90underwent traditionalchemotherapy of Group B, the ORR and OS were76.1%(70/92) vs44.4%(40/90)(P＜0.001),18(months) vs10(months)(P=0.015),respectively. On the whole,the patients received combined treatmentincluding bortezomib had a better ORR and OS than that of the patientsunderwent traditional chemotherapy, the patients without EM receivedcombined treatment of bortezomib got the longest OS;the patients withEM underwent traditional chemotherapy had the worst OS;there were no differences between the patients with EM received combined treatment ofbortezomib and traditional chemotherapy.Conclusion:1.The incidence rate of EM at the diagnosis is9.7%, the mostcommon location of EM is soft tissue.2.Its occurrence is not associated with clinical types, stages, andplasmablasts in bone marrow and FISH genetic testing.3.The prognosis of the patients with EM at diagnosis of MM issignificant inferior to patients without EM.4.The patients received combined treatment including bortezomibhave a better ORR and OS than that of the patients underwent traditionalchemotherapy, the patients without EM received combined treatment ofbortezomib get the longest OS;the patients with EM underwenttraditional chemotherapy have the worst OS.