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Updated: Sep 6, 2025

Interphase Fluorescence in situ Hybridization of Bone Marrow Smears of Multiple Myeloma
Published on: April 15, 2022
[Clinical characteristics and prognosis of 46 patients with macrofocal multiple myeloma]
1State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China.
Abstract:
The clinical characteristics, laboratory results, response to treatment, and prognosis of 46 macrofocal multiple myeloma(MFMM) patients at our center from January 2013 to December 2019 were analyzed retrospectively. The other 92 patients were selected as matched-controls based on diagnostic period and treatment. Among the 1 137 MM patients, 46 patients met the definition criteria of MFMM (4.0%), with median age 56 years, which was not statistically different from whole MM population (P=0.066). According to the international staging system (ISS) and Revised ISS, the proportion of patients with advanced stage in MFMM group was less common than that of controls (P<0.05). More plasmacytomas in MFMM patients were presented (43.5% vs. 18.5%, P<0.05). Regarding cytogenetic abnormalities, there were minor patients manifesting high-risk features in MFMM group (15.8% vs. 32.2%, P=0.058). Translocation(11;14) could be detected in 32.4% MFMM patients and 9.4% typical myeloma patients (P<0.05). The treatment regimens were comparable. As to the best response of treatment, the complete response (CR) rate in MFMM group was significantly higher than that of controls (78.3% vs. 60.9%, P<0.05). The median follow-up time was 37.9 months. The median progression-free survival in MFMM and control groups were 77.5 vs. 39.8 months, respectively (P<0.05). The overall survival (OS) of MFMM patients was significantly longer (not reached vs. 68.2 months, P<0.05).
Insights
Macrofocal multiple myeloma (MFMM) patients showed a higher complete response rate and longer progression-free survival and overall survival compared to typical myeloma patients. MFMM is a distinct subtype with unique characteristics and a better prognosis.
Area of Science:
- Hematology
- Oncology
- Clinical Medicine
Background:
- Macrofocal multiple myeloma (MFMM) is a less common presentation of multiple myeloma.
- Understanding MFMM's distinct clinical features and outcomes is crucial for patient management.
Purpose of the Study:
- To retrospectively analyze the clinical characteristics, treatment response, and prognosis of MFMM patients.
- To compare MFMM outcomes with a matched cohort of typical multiple myeloma (MM) patients.
Main Methods:
- Retrospective analysis of 46 MFMM patients and 92 matched MM controls diagnosed between January 2013 and December 2019.
- Comparison of clinical characteristics, International Staging System (ISS) stages, cytogenetics, treatment response, progression-free survival (PFS), and overall survival (OS).
Main Results:
- MFMM patients presented with more plasmacytomas (43.5% vs 18.5%) and a higher rate of translocation (11;14) (32.4% vs 9.4%).
- MFMM group had a significantly higher complete response (CR) rate (78.3% vs 60.9%).
- MFMM patients demonstrated longer median PFS (77.5 vs 39.8 months) and significantly longer OS (not reached vs 68.2 months).
Conclusions:
- Macrofocal multiple myeloma is characterized by distinct features, including a higher incidence of plasmacytomas and translocation (11;14).
- MFMM patients exhibit superior treatment response and improved long-term survival outcomes compared to typical myeloma.
- MFMM represents a prognostically favorable subtype of multiple myeloma.
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