Revista Brasileira de Hematologia e Hemoterapia Revista Brasileira de Hematologia e Hemoterapia
Hematology,Transfusion and Cell Therapy 2018;40:30-6 DOI: 10.1016/j.bjhh.2017.09.004
Original article
Multiple myeloma and central nervous system involvement: experience of a Brazilian center
Ana Luiza Miranda Silva Dias, , Fabiana Higashi, Ana Lúcia M. Peres, Pricilla Cury, Edvan de Queiroz Crusoé, Vânia Tietsche de Moraes Hungria
Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo, SP, Brazil
Received 30 June 2017, Accepted 15 September 2017
Abstract
Introduction

The estimated involvement of the central nervous system in patients with multiple myeloma is rare at about 1%. The infiltration can be identified at the time multiple myeloma is diagnosed or during its progression. However, it is more common in refractory disease or during relapse.

Methods

This retrospective cohort study reviewed data from medical records of patients followed up at the Gammopathy Outpatient Clinic of Santa Casa de Misericórdia de São Paulo from January 2008 to December 2016.

Results

Twenty patients were included, with a median follow-up of 33.5 months after central nervous system infiltration. The prevalence was 7%. The median age at diagnosis of multiple myeloma was 56.1 years, with 70% of participants being female. Sixteen patients had central nervous system infiltration at diagnosis of multiple myeloma. Seventeen patients had exclusive osteodural lesions and three had infiltrations of the leptomeninge, of which one had exclusive involvement and two had associated osteodural lesions. The median overall survival was 40.3 months after central nervous system involvement. The median overall survival in the group with central nervous system infiltration at relapse was 7.4 months. The patients with leptomeningeal involvement had a median overall survival of 5.8 months.

Conclusion

Central nervous system infiltration is a rare condition, but it should be considered as a possibility in patients with multiple myeloma and neurological symptoms. The best treatment regimen for this condition remains unknown and, in most cases, the prognosis is unfavorable.

Keywords
Central nervous system, Multiple myeloma, Radiotherapy, Chemotherapy, Prognosis
Hematology,Transfusion and Cell Therapy 2018;40:30-6 DOI: 10.1016/j.bjhh.2017.09.004