Extent of disease burden determined with magnetic resonance imaging of the bone marrow is predictive of survival outcome in patients with multiple myeloma

Sikander Ailawadhi, Ahmed N. Abdelhalim, Lyudmyla Derby, Terry L. Mashtare, Kena C. Miller, Gregory E. Wilding, Ronald A. Alberico, Ronald Gottlieb, Donald L. Klippenstein, Kelvin Lee, Asher A. Chanan-Khan

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14 Scopus citations

Abstract

BACKGROUND: Multiple myeloma (MM) remains an incurable cancer. Treatment often is initiated at the time patients experience a progressive increase in tumor burden. The authors of this report investigated magnetic resonance imaging of the bone marrow (BM-MRI) as a novel approach to quantify disease burden and validated a staging system by correlating BM-MRI with common clinical and laboratory parameters. METHODS: The extent of bone marrow involvement was evaluated by BM-MRI. Clinical and laboratory parameters were assessed in patients with active MM, and correlations between variables were assessed statistically. Bone marrow involvement by BM-MRI was defined as stage A (0%), stage B (<10%), stage C (10%-50%), and stage D (>50%). RESULTS: In total, 170 consecutive patients were evaluated (77 women and 93 men), including 144 patients who had active MM. The median age was 61 years (age range, 35-83 years). Advance stage disease (stage >I) based on Durie-Salmon (DS) staging or International Staging System (ISS) criteria was observed in 122 patients (84%) and 77 patients (53%), respectively. Lytic bone disease was noted in 120 patients (83%). There was a significant association between BM-MRI involvement and DS stage (P = .0006), ISS stage (P = .0001), the presence of lytic bone disease (P <.0001) and mean β-2 microglobulin levels (P <.0001). Among the patients with previously untreated MM, there was a significant association between BM-MRI stage and overall survival (OS) (univariate P = .013; multivariate P = .045). Plasmacytosis on bone marrow biopsy at diagnosis was not predictive of OS (P = .91). CONCLUSIONS: BM-MRI is a novel approach for quantifying disease burden in patients with MM. The current investigation in a large cohort of nontransplantion MM patients demonstrated that the extent of bone marrow involvement determined by BM-MRI correlates accurately with other conventional parameters of disease burden and can independently predict survival in patients with MM at the time of initial diagnosis.

Original languageEnglish (US)
Pages (from-to)84-92
Number of pages9
JournalCancer
Volume116
Issue number1
DOIs
StatePublished - Jan 1 2010

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Keywords

  • Disease burden
  • Magnetic resonance imaging
  • Multiple myeloma
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Ailawadhi, S., Abdelhalim, A. N., Derby, L., Mashtare, T. L., Miller, K. C., Wilding, G. E., Alberico, R. A., Gottlieb, R., Klippenstein, D. L., Lee, K., & Chanan-Khan, A. A. (2010). 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(1), 84-92. https://doi.org/10.1002/cncr.24704