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Related Experiment Video

Updated: Dec 25, 2025

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Extramedullary Disease in Multiple Myeloma.

Megan H Jagosky1, Saad Z Usmani2

  • 1Plasma Cell Disorders, Department of Hematologic Oncology & Blood Disorders, Levine Cancer Institute/Atrium Health UNC School of Medicine, Charlotte, NC, USA.

Current Hematologic Malignancy Reports
|March 22, 2020
PubMed
Summary

Extramedullary disease (EMD) in multiple myeloma (MM) is rare but linked to aggressive cancer. This review covers EMD characteristics and treatments for this challenging MM manifestation.

Keywords:
ExtramedullaryImmunomodulatory drugsMultiple myelomaPlasma cell leukemiaProteasome inhibitorTransplant

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Area of Science:

  • Hematology
  • Oncology
  • Internal Medicine

Background:

  • Extramedullary disease (EMD) is a recognized, though rare, manifestation of multiple myeloma (MM).
  • EMD involves organs such as skin, liver, lymphatic system, pleura, and CNS.
  • Incidence is 3-5% in newly diagnosed MM and up to 20% in relapsed MM.

Purpose of the Study:

  • To summarize current data on the characterization of extramedullary disease in multiple myeloma.
  • To review the clinical activity of anti-myeloma agents in patients with EMD.
  • To provide insights into the aggressive nature and potential mechanisms of EMD.

Main Methods:

  • Literature review of studies on extramedullary disease in multiple myeloma.
  • Analysis of disease characteristics, including association with aggressive phenotypes and cytogenetics.
  • Evaluation of treatment strategies and outcomes for EMD in MM.

Main Results:

  • EMD is associated with a more aggressive multiple myeloma phenotype.
  • Elevated lactate dehydrogenase (LDH) and high-risk cytogenetics (del(17p), t(4;14), t(14;16)) are linked to EMD.
  • Treatment generally follows protocols for high-risk multiple myeloma.

Conclusions:

  • Extramedullary disease represents an aggressive form of multiple myeloma.
  • Understanding EMD's characteristics is crucial for appropriate patient management.
  • Further research is needed to optimize therapeutic strategies for EMD in MM.