CLINICAL FEATURES OF THE EXTRAMEDULLARY DISEASE IN MULTIPLE MYELOMA

Purpose. To investigate clinical features of the extramedullary myeloma and evaluate the efficacy of the high-dose chemotherapy with autologous stem-cell transplantation (autoSCT). Material and methods. 18 patients (9 men and 9 women) aged of from 23 to 73 years with de novo multiple myeloma were included in the study. All patients had the multiple myeloma with plasmacytomas, 15 patients had soft-tissue plasmacytomas and 3 patients had the extramedullary disease with the involvement of the liver, stomach, submandibular region. Results. Clinical features of soft-tissue plasmacytomas and the extramedullary disease in de novo multiple myeloma are characterized by a reduced rate of the achievement of a complete response. At the same time, the use of the high-dose chemotherapy with autoSCT allows get the complete remission in some cases. The overall anti-tumor response (complete response + very good partial response + partial response) after the induction phase of the treatment was achieved in 46.6% of soft-tissue plasmacytomas patients. 10 patients from this group underwent ASCT. All treated patients are alive nowadays, the observation period from the time of diagnosis ranged from 12 to 57 months (median 36 months). 2 patients with the extramedullary disease received ASCT, but a complete response after the transplantation failed to persist for a long time, the systemic relapse developed 3 and 18 months later. 2 patients with the high Ki-67 new extramedullary foci were found to appear against the background of the specific therapy, or almost immediately after the transplantation. The presence of the high CXCR4 expression may be a beneficial factor for the remission without extramedullary relapse with plasmacytomas.