A case of myelomatous meningitis

Ackroyd, Sam; Swirsky, D; Kay, Clive; Parapia, L. A.

doi:10.1111/j.1365-2141.2004.05091.x

Cited by 6 publications

(7 citation statements)

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“…We found 37 case reports, describing isolated CNS MM cases, and two reports of series of 18 and 54 patients respectively (3, 4). The data of a total of 109 patients were reviewed (3–77).…”

Section: Resultsmentioning

confidence: 99%

Central nervous system myelomatosis: review of the literature

Nieuwenhuizen

Biesma

2007

European J of Haematology

104

179

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Involvement of the central nervous system (CNS) in multiple myeloma (MM) is very uncommon; it has been observed in approximately 1% of the MM patients. This review summarizes the clinical and laboratory characteristics and treatment modalities of 109 patients with CNS myelomatosis (CNS MM) reported in the literature. CNS MM has a wide spectrum of neurological symptoms and signs. No guidelines for therapy of CNS MM are available, which has resulted in a large variation in the treatment schedules. Treatment options include intrathecal chemotherapy (IT), systemic chemotherapy (SC), cranial irradiation (CI) or a combination. The prognosis of CNS MM remains poor, with an overall median survival from the time of diagnosis to death of 2.0 months (range 0.1–25 months). Patients who were treated with CI had a significantly (P = 0.004) longer survival when compared with patients without CI.

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Section: Resultsmentioning

confidence: 99%

Central nervous system myelomatosis: review of the literature

Nieuwenhuizen

Biesma

2007

European J of Haematology

104

179

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“…In fact, by using flow cytometry, the CD56 molecule was found on MM plasma cells from additional cases of CNS-MM the patients with CNS-MM 15,16,21,23,40 and in our patient. In addition, Rasche et al reported positivity for CD56 in eight of ten patients with extramedullary relapse of MM, using immunohistochemical assays.…”

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confidence: 96%

“…In a previous clinical study concerning either cases of CNS-MM or other extramedullary sites of localization of MM, immunocytochemical techniques were applied, with the evidence of substantial lack of CD56 expression. 21,[34][35][36][37][38][39][40] The hypothesis that CD56 down-regulation might favor the migration of MM plasma cells from the bone marrow was put forward.…”

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confidence: 99%

Myelomatous Meningitis Evaluated by Multiparameter Flow Cytometry : Report of a Case and Review of the Literature

Marini

Carulli

Lari

et al. 2014

J Clin Exp Hematopathol

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Central nervous system (CNS) involvement in multiple myeloma (MM) is uncommon. Among its possible presentations, leptomeningeal involvement of MM, also termed central nervous system myelomatosis (CNS-MM) is rare and is characterized by the presence of neoplastic plasma cells in the cerebrospinal fluid (CSF). So far, 187 cases of CNS-MM have been reported : the great majority of them were diagnosed by cytological assays and flow cytometry was used in only eight cases. We describe a case of CNS-MM in a 62-year-old woman, previously treated with chemotherapy (VTD) and autologous peripheral blood hematopoietic stem cell transplantation for stage IIIB IgG-l MM. After achieving a very good partial response, the patient showed progression of disease, with an extramedullary localization. During administration of second-line therapy, the patient showed severe neurological symptoms. MRI resulted negative. Diagnosis of CNS-MM was made by multiparameter flow cytometry, which showed the presence of CD56 + plasma cells in a CSF sample, in the absence of plasma cell leukemia. In this paper we also present a review of the eight previous cases of CNS-MM diagnosed by flow cytometry. We found that the application of flow cytometry in cases of MM with neurological symptoms allows a rapid diagnosis of CNS-MM and provides useful information about plasma cell phenotype (including CD56 expression). Some cases of CNS-MM are characterized by normal MRI. In addition, some evidences deriving from the review of literature suggest that CSF monitoring by flow cytometry in such cases might be used to evaluate the efficacy of drugs capable of crossing the blood-brain barrier. 〔J Clin Exp Hematop 54 (2) : 129-136, 2014〕

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“…This complication appeared in the majority of the patients as a terminal event [7], but it was also reported as a presenting feature of MM [5]. Moreover, a few cases of meningeal involvement were reported in patients who had been successfully treated with high-dose therapy and stem cell rescue and had no overt medullary plasmacytosis [4,5].…”

Section: Discussionmentioning

confidence: 98%