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Hematol Oncol. 2016 Mar;34(1):2-8. doi: 10.1002/hon.2185. Epub 2014 Dec 19.

Overview of recent trends in diagnosis and management of leptomeningeal multiple myeloma.

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Division of Hematology/Oncology, Stem Cell Transplantation, University of Cincinnati, Cincinnati, OH, USA.
Marshfield Clinic Cancer Care at St. Michaels, Stevens Point, WI, USA.
Marshfield Clinic Weston Center, Department of Hematology/Oncology, Weston, WI, USA.


Neurological complications related to multiple myeloma (MM) are not uncommon; however, direct involvement of the central nervous system (CNS) is extremely rare and represents a diagnostic and therapeutic challenge. Significant survival difference has been noted with the introduction of novel therapy in patients with MM, but their effect on the incidence and their use for management of leptomeningeal myeloma (LMM) is uncertain. Analysis of published data demonstrates its recent increased incidence, median time to CNS presentation, and slight improvement in median survival after diagnosis of LMM. Less common MM isotypes have been overrepresented in LMM. CNS relapse occurred mostly in patients with Durie-Salmon stage III MM. Despite treatments, standard or experimental, the survival rates of LMM remain dismal. Monitoring high risk patients closely, even after achieving complete remission, may be useful in early detection of LMM. As we gain better understanding of LMM, we recommend that future research and clinical care focus on earlier diagnosis and development of more efficient CNS-directed therapy to improve survival in this patient population.


central nervous system; metastasis; multiple myeloma

[Indexed for MEDLINE]

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