Multiple myeloma natural history: Difference between revisions
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==Overview== | ==Overview== | ||
If left untreated, most of patients with multiple myeloma may progress to develop fatigue, bone pain, and [[pallor]].<ref>Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Prognosis</ref> Complications that can develop as a result of multiple myeloma are [[anemia]], [[renal failure]],skeletal complications, and neurological complications.<ref>{{Cite web | last = | first = | title = Myeloma - SEER Stat Fact Sheets | url = http://seer.cancer.gov/statfacts/html/mulmy.html | publisher = | date = | accessdate = 17 February 2014 }}</ref> The prognosis of multiple myeloma is good with treatment. Without treatment, multiple myeloma will result in death with a median survival of 7 months. Multiple myeloma is associated with a 10 year survival of 3%. The presence of [[plasma cell leukemia]] or soft tissue plasmacytomas is associated with a particularly poor prognosis among patients with multiple myeloma.<ref>Plasma cell neoplasm. Cancer.gov (2015)http://www.cancer.gov/types/myeloma/hp/myeloma-treatment-pdq#link/_40_toc </ref> According to a report published by National Cancer Institute there is a 43.25% chance of 5 year survival.<ref>{{Cite web | last = | first = | title = Myeloma - SEER Stat Fact Sheets | url = http://seer.cancer.gov/statfacts/html/mulmy.html | publisher = | date = | accessdate = 17 February 2014 }}</ref> | If left untreated, most of patients with multiple myeloma may progress to develop fatigue, bone pain, and [[pallor]].<ref>Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Prognosis</ref> Complications that can develop as a result of multiple myeloma are [[anemia]], [[renal failure]], skeletal complications, and neurological complications.<ref>{{Cite web | last = | first = | title = Myeloma - SEER Stat Fact Sheets | url = http://seer.cancer.gov/statfacts/html/mulmy.html | publisher = | date = | accessdate = 17 February 2014 }}</ref> The prognosis of multiple myeloma is good with treatment. Without treatment, multiple myeloma will result in death with a median survival of 7 months. Multiple myeloma is associated with a 10 year survival of 3%. The presence of [[plasma cell leukemia]] or soft tissue plasmacytomas is associated with a particularly poor prognosis among patients with multiple myeloma.<ref>Plasma cell neoplasm. Cancer.gov (2015)http://www.cancer.gov/types/myeloma/hp/myeloma-treatment-pdq#link/_40_toc </ref> According to a report published by National Cancer Institute there is a 43.25% chance of 5 year survival.<ref>{{Cite web | last = | first = | title = Myeloma - SEER Stat Fact Sheets | url = http://seer.cancer.gov/statfacts/html/mulmy.html | publisher = | date = | accessdate = 17 February 2014 }}</ref> | ||
==Natural History== | ==Natural History== | ||
Revision as of 16:00, 20 September 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
If left untreated, most of patients with multiple myeloma may progress to develop fatigue, bone pain, and pallor.[1] Complications that can develop as a result of multiple myeloma are anemia, renal failure, skeletal complications, and neurological complications.[2] The prognosis of multiple myeloma is good with treatment. Without treatment, multiple myeloma will result in death with a median survival of 7 months. Multiple myeloma is associated with a 10 year survival of 3%. The presence of plasma cell leukemia or soft tissue plasmacytomas is associated with a particularly poor prognosis among patients with multiple myeloma.[3] According to a report published by National Cancer Institute there is a 43.25% chance of 5 year survival.[4]
Natural History
- Most patients with multiple myeloma are initially asymptomatic. If left untreated, most of the patients with multiple myeloma will gradually develop fatigue, bone pain, and pallor.[5]
- In as many as 30-40% cases the diagnosis may be incidental and is often diagnosed on routine blood screening.
- As the tumor grows larger people may notice one or more of the symptoms.[6]
Complications
Complications that can develop as a result of multiple myeloma are divided into:[7]
- Local complications:
- Hematologic complications, usually results from the replacement of normal bone marrow by infiltrating tumor cells and inhibition of normal (hematopoiesis) by cytokines
- Normocytic and normochromic anemia
- Bleeding disorders
- Pancytopenia due to bone marrow failure
- Skeletal complications
- Pathologic fractures
- Spinal cord compression present as back pain, numbness, dysthesias suggestive, loss of bowel or bladder control.
- Systemic complications:
- Hypercalcemia
- Renal insufficiency, may develop both acutely and chronically.
- Neurologic complications
- Infections
Prognosis
- The prognosis of multiple myeloma is good with treatment. Without treatment, multiple myeloma will result in death with a median survival of 7 months. Multiple myeloma is associated with a 10 year survival of 3%. The presence of plasma cell leukemia or soft tissue plasmacytomas is associated with a particularly poor prognosis among patients with multiple myeloma.[8]
- Overall mortality rates peaked in the mid-1990s and have fallen in recent years with the introduction of better therapeutic interventions.[9]
- The average survival of multiple myeloma patients is approximately 3 years and approximately 43.5% of patients survive after 5 years.[10]
- The International Staging System can help to predict survival, with a median survival of 62 months for stage 1 disease, 45 months for stage 2 disease, and 29 months for stage 3 disease.[11][12]:
- Cytogenetic analysis of multiple myeloma cells may be of prognostic value, with deletion of chromosome 13, non-hyperdiploidy and the balanced translocations t(4;14) and t(14;16) conferring a poorer prognosis. The 11q13 and 6p21 cytogenetic abnormalities are associated with a better prognosis.[13]
- Prognostic markers such as these are always generated by retrospective analyses, and it is likely that new treatment developments will improve the outlook for those with traditionally 'poor-risk' disease.
References
- ↑ Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Prognosis
- ↑ "Myeloma - SEER Stat Fact Sheets". Retrieved 17 February 2014.
- ↑ Plasma cell neoplasm. Cancer.gov (2015)http://www.cancer.gov/types/myeloma/hp/myeloma-treatment-pdq#link/_40_toc
- ↑ "Myeloma - SEER Stat Fact Sheets". Retrieved 17 February 2014.
- ↑ Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Prognosis. Accessed on September, 20th 2015
- ↑ Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Prognosis. Accessed on September, 20th 2015
- ↑ Bladé, J.; Rosiñol, L. (2007). "Complications of multiple myeloma". Hematol Oncol Clin North Am. 21 (6): 1231–46, xi. doi:10.1016/j.hoc.2007.08.006. PMID 17996596. Unknown parameter
|month=ignored (help) - ↑ Plasma cell neoplasm. Cancer.gov (2015)http://www.cancer.gov/types/myeloma/hp/myeloma-treatment-pdq#link/_40_toc
- ↑ A snapshot of myeloma. National cancer institute(2014)http://www.cancer.gov/research/progress/snapshots/myeloma
- ↑ "Myeloma - SEER Stat Fact Sheets". Retrieved 17 February 2014.
- ↑ Greipp PR, San Miguel J, Fonseca R, Avet-Loiseau H, Jacobson JL, Rasmussen E, Crowley J, Durie BMG. Development of an international prognostic index (IPI) for myeloma: report of the international myeloma working group. Hematology Journal 2003;4:S42. NLM ID 100965523.
- ↑ About multiple myeloma. University of California San Francisco (2015)http://cancer.ucsf.edu/research/multiple-myeloma/ Accessed on September, 18 2015
- ↑ Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Prognosis