{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T19:15:06Z","timestamp":1790190906825,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T00:00:00Z","timestamp":1719878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Central nervous system (CNS) involvement is a rare and aggressive complication of multiple myeloma (MM). We identified 54\/4352\u2009MM patients (1.2%), who developed CNS\u2010MM between 2000 and 2022. A matched\u2010control group of MM patients without CNS\u2010MM was used for comparisons. Median age was 63\u2009years. Median time to CNS\u2010MM was 28\u2009months; 6\/54 experienced CNS\u2010MM at MM diagnosis. Abnormal lactate dehydrogenase (LDH), high\u2010risk cytogenetics, and extramedullary involvement (EMI), that is, soft tissue plasmacytomas and\/or plasma cell leukemia (PCL), were more frequent in CNS\u2010MM versus controls (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u2009.05); 13\/54 had PCL at CNS\u2010MM. The majority had leptomeningeal infiltration (LMI) (66%); 26% had CNS\u2010MM without systemic myeloma; EMI was the strongest predictor for CNS\u2010MM (OR: 6.3). Median overall survival (OS) of CNS\u2010MM patients versus controls was 43\u2009months (95% CI: 32\u201354) versus 60\u2009months (95% CI: 38\u201382) (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u2009.001); treatment of CNS\u2010MM included mainly bortezomib\/thalidomide\/chemotherapy whereas 20% received novel drugs\/immunotherapy combinations; 28 patients underwent cerebrospinal fluid infusions; EMI was the strongest negative predictor for post CNS\u2010MM OS (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.005; HR: 2.9). Treatment after 2016 predicted significantly for OS (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.002; HR: 0.27). Median post CNS\u2010MM OS was 4\u2009months (95% CI: 2.6\u20135.4); in patients treated after 2016 median OS was 12\u2009months. In conclusion, we have demonstrated in this large real\u2010world series that survival of CNS\u2010MM remains poor; however, there is a positive impact of treatment after 2016, related to the efficacy of modern anti\u2010myeloma therapy; EMI significantly increases the probability to develop CNS\u2010MM and the risk of post CNS\u2010MM death, indicating a potential need for CNS prophylaxis for those patients.\n                  <\/jats:p>","DOI":"10.1002\/ajh.27425","type":"journal-article","created":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T07:15:19Z","timestamp":1719904519000},"page":"1897-1905","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Central nervous system multiple myeloma: A real\u2010world multi\u2010institutional study of the Greek Myeloma Study Group"],"prefix":"10.1002","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9404-807X","authenticated-orcid":false,"given":"Eirini","family":"Katodritou","sequence":"first","affiliation":[{"name":"Department of Hematology Theagenio Cancer Hospital  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6987-4716","authenticated-orcid":false,"given":"Dimitra","family":"Dalampira","sequence":"additional","affiliation":[{"name":"Department of Hematology Theagenio Cancer Hospital  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7523-7510","authenticated-orcid":false,"given":"Sosana","family":"Delimpasi","sequence":"additional","affiliation":[{"name":"Department of Hematology and Bone Marrow Transplantation Unit Evangelismos Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6328-9783","authenticated-orcid":false,"given":"Ioannis","family":"Ntanasis\u2010Stathopoulos","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fryni","family":"Karaolidou","sequence":"additional","affiliation":[{"name":"Department of Hematology and Bone Marrow Transplantation Unit Evangelismos Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annita\u2010Ioanna","family":"Gkioka","sequence":"additional","affiliation":[{"name":"First Department of Propaedeutic Internal Medicine, Laikon General Hospital National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasiliki","family":"Labropoulou","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology University of Patras Medical School  Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanouil","family":"Spanoudakis","sequence":"additional","affiliation":[{"name":"Department of Hematology University Hospital of Alexandroupolis  Alexandroupolis Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodora","family":"Triantafyllou","sequence":"additional","affiliation":[{"name":"Department of Hematology Theagenio Cancer Hospital  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Kotsopoulou","sequence":"additional","affiliation":[{"name":"Department of Haematology Metaxa Cancer Hospital  Piraeus Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyrydiki","family":"Michalis","sequence":"additional","affiliation":[{"name":"Department of Hematology \u201cG. Gennimatas\u201d General Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chrysanthi","family":"Vadikolia","sequence":"additional","affiliation":[{"name":"424 Military Hospital  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodosia","family":"Papadopoulou","sequence":"additional","affiliation":[{"name":"Department of Hematology Theagenio Cancer Hospital  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aggeliki","family":"Sevastoudi","sequence":"additional","affiliation":[{"name":"Department of Hematology Theagenio Cancer Hospital  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Michael","sequence":"additional","affiliation":[{"name":"Hematology Department Bank of Cyprus Oncology Center  Nicosia 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