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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, while without treatment, multiple myeloma will result in death with a median survival of 7 months.<ref>Multiple myeloma. National Cancer Institute(2015) www.cancer.gov/types/myeloma/hp/myeloma-treatment-pdq#link/_40_toc Accessed on September, 20th 2015</ref><ref>Multiple myeloma. Librepathology (2015)http://www.wikidoc.org/index.php?title=Multiple_myeloma_pathophysiology&action=edit&section Accessed on September, 20th 2015=1</ref> 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 Accessed on September, 20th 2015</ref> According to a report published by National Cancer Institute there is a 43.25% chance of 5 year survival.<ref>Multiple myeloma. National Cancer Institute(2015) www.cancer.gov/types/myeloma/hp/myeloma-treatment-pdq#link/_40_toc Accessed on September, 20th 2015</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>Multiple myeloma. National Cancer Institute(2015) www.cancer.gov/types/myeloma/hp/myeloma-treatment-pdq#link/_40_toc Accessed on September, 20th 2015</ref>
The prognosis of multiple myeloma is good with treatment, while without treatment, multiple myeloma will result in death with a median survival of 7 months.<ref>Multiple myeloma. National Cancer Institute(2015) www.cancer.gov/types/myeloma/hp/myeloma-treatment-pdq#link/_40_toc Accessed on September, 20th 2015</ref><ref>Multiple myeloma. Librepathology (2015)http://www.wikidoc.org/index.php?title=Multiple_myeloma_pathophysiology&action=edit&section Accessed on September, 20th 2015=1</ref> 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 Accessed on September, 20th 2015</ref> According to a report published by National Cancer Institute there is a 43.25% chance of 5 year survival.<ref>Multiple myeloma. National Cancer Institute(2015) www.cancer.gov/types/myeloma/hp/myeloma-treatment-pdq#link/_40_toc Accessed on September, 20th 2015</ref>


==Natural History==
==Natural History==
Line 38: Line 39:
==Prognosis==
==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.<ref>Multiple myeloma. National Cancer Institute(2015) www.cancer.gov/types/myeloma/hp/myeloma-treatment-pdq#link/_40_toc Accessed on September, 20th 2015</ref><ref>Multiple myeloma. Librepathology (2015)http://www.wikidoc.org/index.php?title=Multiple_myeloma_pathophysiology&action=edit&section Accessed on September, 20th 2015=1</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.<ref>Multiple myeloma. National Cancer Institute(2015) www.cancer.gov/types/myeloma/hp/myeloma-treatment-pdq#link/_40_toc Accessed on September, 20th 2015</ref><ref>Multiple myeloma. Librepathology (2015)http://www.wikidoc.org/index.php?title=Multiple_myeloma_pathophysiology&action=edit&section Accessed on September, 20th 2015=1</ref>
*Overall the 5-year survival rate of multiple myeloma is around 46.6%.<ref>Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Prognosis Accessed on September, 20th 2015</ref>
*Overall the 5-year survival rate of multiple myeloma is around 46.6%.<ref>Multiple myeloma. National Cancer Institute(2015) www.cancer.gov/types/myeloma/hp/myeloma-treatment-pdq#link/_40_toc Accessed on September, 20th 2015</ref><ref>Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Prognosis Accessed on September, 20th 2015</ref>
*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>  
*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>  
*Overall mortality rates peaked in the mid-1990s and have fallen in recent years with the development of new therapeutic interventions.<ref>A snapshot of myeloma. National cancer institute(2014)http://www.cancer.gov/research/progress/snapshots/myeloma</ref>
*Overall mortality rates peaked in the mid-1990s and have fallen in recent years with the development of new therapeutic interventions.<ref>A snapshot of myeloma. National cancer institute(2014)http://www.cancer.gov/research/progress/snapshots/myeloma</ref>
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*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.<ref name="ISS">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.</ref><ref>About multiple myeloma. University of California San Francisco (2015)http://cancer.ucsf.edu/research/multiple-myeloma/ Accessed on September, 18 2015 </ref>:
*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.<ref name="ISS">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.</ref><ref>About multiple myeloma. University of California San Francisco (2015)http://cancer.ucsf.edu/research/multiple-myeloma/ Accessed on September, 18 2015 </ref>:
*[[Cytogenetic]] analysis of multiple myeloma cells may be of [[prognosis|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.<ref>Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Prognosis Accessed on September, 20th 2015</ref>
*[[Cytogenetic]] analysis of multiple myeloma cells may be of [[prognosis|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.<ref>Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Prognosis Accessed on September, 20th 2015</ref>
*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==
==References==

Revision as of 12:12, 21 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, while without treatment, multiple myeloma will result in death with a median survival of 7 months.[3][4] 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.[5] According to a report published by National Cancer Institute there is a 43.25% chance of 5 year survival.[6]

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.[7]
  • 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.[8]

Complications

Complications that can develop as a result of multiple myeloma are divided into:[9]

  • 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
  • Systemic 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.[10][11]
  • Overall the 5-year survival rate of multiple myeloma is around 46.6%.[12][13]
  • The presence of plasma cell leukemia or soft tissue plasmacytomas is associated with a particularly poor prognosis among patients with multiple myeloma.[14]
  • Overall mortality rates peaked in the mid-1990s and have fallen in recent years with the development of new therapeutic interventions.[15]
  • The average survival of multiple myeloma patients is approximately 3 years and approximately 43.5% of patients survive after 5 years.[16]
  • 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.[17][18]:
  • 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.[19]


References

  1. ↑ Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Prognosis
  2. ↑ Multiple myeloma. National Cancer Institute(2015) www.cancer.gov/types/myeloma/hp/myeloma-treatment-pdq#link/_40_toc Accessed on September, 20th 2015
  3. ↑ Multiple myeloma. National Cancer Institute(2015) www.cancer.gov/types/myeloma/hp/myeloma-treatment-pdq#link/_40_toc Accessed on September, 20th 2015
  4. ↑ Multiple myeloma. Librepathology (2015)http://www.wikidoc.org/index.php?title=Multiple_myeloma_pathophysiology&action=edit&section Accessed on September, 20th 2015=1
  5. ↑ Plasma cell neoplasm. Cancer.gov (2015)http://www.cancer.gov/types/myeloma/hp/myeloma-treatment-pdq#link/_40_toc Accessed on September, 20th 2015
  6. ↑ Multiple myeloma. National Cancer Institute(2015) www.cancer.gov/types/myeloma/hp/myeloma-treatment-pdq#link/_40_toc Accessed on September, 20th 2015
  7. ↑ Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Prognosis. Accessed on September, 20th 2015
  8. ↑ Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Prognosis. Accessed on September, 20th 2015
  9. ↑ 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)
  10. ↑ Multiple myeloma. National Cancer Institute(2015) www.cancer.gov/types/myeloma/hp/myeloma-treatment-pdq#link/_40_toc Accessed on September, 20th 2015
  11. ↑ Multiple myeloma. Librepathology (2015)http://www.wikidoc.org/index.php?title=Multiple_myeloma_pathophysiology&action=edit&section Accessed on September, 20th 2015=1
  12. ↑ Multiple myeloma. National Cancer Institute(2015) www.cancer.gov/types/myeloma/hp/myeloma-treatment-pdq#link/_40_toc Accessed on September, 20th 2015
  13. ↑ Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Prognosis Accessed on September, 20th 2015
  14. ↑ Plasma cell neoplasm. Cancer.gov (2015)http://www.cancer.gov/types/myeloma/hp/myeloma-treatment-pdq#link/_40_toc
  15. ↑ A snapshot of myeloma. National cancer institute(2014)http://www.cancer.gov/research/progress/snapshots/myeloma
  16. ↑ "Myeloma - SEER Stat Fact Sheets". Retrieved 17 February 2014.
  17. ↑ 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.
  18. ↑ About multiple myeloma. University of California San Francisco (2015)http://cancer.ucsf.edu/research/multiple-myeloma/ Accessed on September, 18 2015
  19. ↑ Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Prognosis Accessed on September, 20th 2015


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