Prognostic Factors of Hillengass et al for a Patient with Asymptomatic Multiple Myelomas, Including Focal Lesions in Bone Detected by Whole Body MRI

Description

Hillengass et al evaluated whole body magnetic resonance imaging (MRI) as a means of evaluating a patient with asymptomatic multiple myeloma. They identified the presence of focal lesions in bone as a means to identify a patient who may benefit from more aggressive management. The authors are from University Hospital Heidelberg and the German Cancer Research Center.

Imaging studies: whole body MRI (to include axial and appendicular skeleton)

MRI-related prognostic factors identified by multivariate analysis

(1) >=2 focal lesions in bone

(2) diffuse bone marrow infiltration

Progression by 3 years occurred in 30% with 0 or 1 focal lesions and in 70% with 2 or more.

Additional prognostic factors not based on MRI findings:

(1) reduction in polyclonal immunoglobulins (uninvolved immunoglobulins)

(2) serum M protein >= 4 g/dL

(3) presence of IgA monoclonal protein

(4) presence of Bence-Jones protein in the urine

(5) plasma cell infiltrate in the bone marrow >= 20%

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Description

Specialty

ICD-10