Tucker Susan M, Zaihra Tasneem
Division of Ophthalmology, Lahey Hospital & Medical Center, Peabody, MA, USA.
Department of Surgery, Lahey Hospital & Medical Center, Burlington, MA, USA.
Orbit. 2023 Dec;42(6):603-611. doi: 10.1080/01676830.2023.2166082. Epub 2023 Jan 25.
To describe cytogenetic abnormalities in five patients with orbital involvement of multiple myeloma (MM) and to determine if high-risk cytogenetic abnormalities were more prevalent in patients with extramedullary disease (EMD). The final goal was to determine predictors of poor survival in the entire cohort.
Retrospective cohort study of 315 patients diagnosed with multiple myeloma over a 9-year period at a single institution.
Males comprised 61% of the 315 patients and the majority (54.3%) were stage II at diagnosis of MM. Follow-up ranged 6 months to 18 years, mean 5.3 ± 3.7 years. Eight patients (2.5%), two of which had orbital involvement, developed EMD and an additional three patients had orbital involvement from adjacent bone disease. No genetic abnormality reached statistical significance between non-EMD and EMD groups. At the time of analysis 127 (41%) non-EMD patients and 6 (75%) EMD patients have died. The median survival time for the EMD group was 2 years, whereas for the non-EMD group it was 9 years (-value of log rank test = .00015). Stage at time of MM diagnosis and age were associated with worse prognosis. Median survival for patients over 65 years of age was 7 years, compared to 12 years for patients 65 or younger (-value for the log-ranked test <.001).
Cytogenetic abnormalities are described in five patients with orbital involvement of MM. No genetic abnormality reached statistical significance between non-EMD and EMD groups. EMD status, stage of MM at diagnosis and age are associated with poorer overall survival. MM: Multiple Myeloma; EMD: Extramedullary disease; FISH: fluorescence in situ hybridization; B2M: beta-2 microglobulin; LDH: lactate dehydrogenase; OS: overall survival.
描述5例眼眶受累的多发性骨髓瘤（MM）患者的细胞遗传学异常情况，并确定高危细胞遗传学异常在髓外疾病（EMD）患者中是否更普遍。最终目标是确定整个队列中生存不良的预测因素。
对在单一机构9年期间诊断为多发性骨髓瘤的315例患者进行回顾性队列研究。
315例患者中男性占61%，大多数（54.3%）在MM诊断时为II期。随访时间为6个月至18年，平均5.3±3.7年。8例患者（2.5%）发生EMD，其中2例有眼眶受累，另外3例因相邻骨病有眼眶受累。非EMD组和EMD组之间没有基因异常达到统计学意义。在分析时，127例（41%）非EMD患者和6例（75%）EMD患者已经死亡。EMD组的中位生存时间为2年，而非EMD组为9年（对数秩检验P值=.00015）。MM诊断时的分期和年龄与预后较差相关。65岁以上患者的中位生存时间为7年，65岁或以下患者为12年（对数秩检验P值<.001）。
描述了5例眼眶受累的MM患者的细胞遗传学异常情况。非EMD组和EMD组之间没有基因异常达到统计学意义。EMD状态、MM诊断时的分期和年龄与总体生存率较差相关。MM：多发性骨髓瘤；EMD：髓外疾病；FISH：荧光原位杂交；B2M：β2微球蛋白；LDH：乳酸脱氢酶；OS：总体生存。
