{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T15:25:10Z","timestamp":1768922710200,"version":"3.49.0"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T00:00:00Z","timestamp":1682035200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>No adequate data exist on the impact of multiple myeloma (MM) with extramedullary disease (EMD) after autograft and maintenance therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified 808 patients with newly diagnosed MM who received first autograft, of whom 107 had EMD (83 paraskeletal and 24 organ involvement), and who had been reported to the EBMT registry December 2018. Distribution according to type of involvement was similar between the treatment groups (<jats:italic>p<\/jats:italic>\u2009=\u2009.69). For EMD, 46 (40%) received thalidomide, 59 (51%) lenalidomide, and 11 (10%) bortezomib.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median follow\u2010up from maintenance start was 44\u2009months. Three\u2010year progression\u2010free survival (PFS) was 52% (48%\u201357%) for no EMD, 56% (44%\u201369%) for paraskeletal involvement, and 45% (22%\u201368%) for organ involvement (<jats:italic>p<\/jats:italic>\u2009=\u2009.146). Early PFS (within first year) appeared to be significantly worse for organ involvement (hazard ratio, 3.40), while no significant influence was found after first year from maintenance start. Three\u2010year overall survival (OS) was 81% (77%\u201384%), 88% (80%\u201396%), and 68% (47%\u201389%; <jats:italic>p<\/jats:italic>\u2009=\u2009.064), respectively. With thalidomide as reference, lenalidomide was significantly associated with better PFS and OS, whereas bortezomib appeared to improve outcome specifically in EMD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Lenalidomide maintenance is standard of care for MM without EMD, whereas extramedullary organ involvement remains a significant risk factor for worse outcome, especially for early events after maintenance start.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.13981","type":"journal-article","created":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T07:10:12Z","timestamp":1682061012000},"page":"181-190","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Impact of newly diagnosed extramedullary myeloma on outcome after first autograft followed by maintenance: A <scp>CMWP\u2010EBMT<\/scp> study"],"prefix":"10.1111","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0891-1744","authenticated-orcid":false,"given":"Nico","family":"Gagelmann","sequence":"first","affiliation":[{"name":"Department of Stem Cell Transplantation University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirk\u2010Jan","family":"Eikema","sequence":"additional","affiliation":[{"name":"Department of Statistics Leiden University Medical Centre  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Koster","sequence":"additional","affiliation":[{"name":"EBMT Data Office  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanja","family":"Netelenbos","sequence":"additional","affiliation":[{"name":"Haga Teaching Hospital  Hague The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"McDonald","sequence":"additional","affiliation":[{"name":"Alberts Cellular Therapy, Pretoria East Hospital  Pretoria South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne\u2010Marie","family":"Stoppa","sequence":"additional","affiliation":[{"name":"Institut Paoli Calmettes  Marseille France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roland","family":"Fenk","sequence":"additional","affiliation":[{"name":"Department of Hematology, Oncology and Clinical Immunology University Hospital D\u00fcsseldorf, Medical Faculty, Heinrich Heine University  D\u00fcsseldorf Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Achilles","family":"Anagnostopoulos","sequence":"additional","affiliation":[{"name":"Department of Hematology and HCT Unit G. Papanikolaou Hospital  Thessaloniki Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7327-7834","authenticated-orcid":false,"given":"Gwendolyn","family":"van Gorkom","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology, GROW School for Oncology and Developmental Biology Maastricht University Medical Center  Maastricht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6006-8088","authenticated-orcid":false,"given":"Eric","family":"Deconinck","sequence":"additional","affiliation":[{"name":"Clinical Hematology Besan\u00e7on University Hospital  Besan\u00e7on France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claude\u2010Eric","family":"Bulabois","sequence":"additional","affiliation":[{"name":"Service d'Hematologie CHU Grenoble Alpes\u2010Universite Grenoble Alpes  Grenoble France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel","family":"Delforge","sequence":"additional","affiliation":[{"name":"University Hospital Leuven  Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald","family":"Bunjes","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Bone Marrow Transplantation Unit University Hospital of Ulm  Ulm Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Arcese","sequence":"additional","affiliation":[{"name":"Department of Biomedicine and Prevention University of Rome Tor Vergata  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P\u00e9ter","family":"Rem\u00e9nyi","sequence":"additional","affiliation":[{"name":"St. Istv\u00e1n and St. L\u00e1szl\u00f3 Hospital of Budapest  Budapest Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maija","family":"It\u00e4l\u00e4\u2010Remes","sequence":"additional","affiliation":[{"name":"Turku University Hospital, Stem Cell Transplantation Unit  Turku Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenz","family":"Thurner","sequence":"additional","affiliation":[{"name":"Department of Oncology, Hematology, Rheumatology and Clinical Immunology Saarland University Medical Center  Homburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0651-5462","authenticated-orcid":false,"given":"Ali Zahit","family":"Bolaman","sequence":"additional","affiliation":[{"name":"Internal Medicine, Division of Hematology Adnan Menderes University  Aydin Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yafour","family":"Nabil","sequence":"additional","affiliation":[{"name":"\u00c9tablissement hospitalier et universitaire, Service d'h\u00e9matologie et de th\u00e9rapie cellulaire Universit\u00e9 d'Oran 1, Ahmed Ben Bella, facult\u00e9 de m\u00e9decine  Oran Algeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johan","family":"Lund","sequence":"additional","affiliation":[{"name":"Department of Cellular Therapy and Allogeneic Stem Cell Transplantation Karolinska Institute &amp; University Hospital  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H\u00e9l\u00e8ne","family":"Labussi\u00e8re\u2010Wallet","sequence":"additional","affiliation":[{"name":"Service d'H\u00e9matologie, H\u00f4pital Lyon Sud  Pierre B\u00e9nite France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1374-4503","authenticated-orcid":false,"given":"Patrick J.","family":"Hayden","sequence":"additional","affiliation":[{"name":"Department of Haematology, St. James's Hospital  Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meral","family":"Beksac","sequence":"additional","affiliation":[{"name":"Cebeci Yerleskesi Dikimevi  Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Sch\u00f6nland","sequence":"additional","affiliation":[{"name":"Medical Department V, Amyloidosis Center Heidelberg University Hospital  Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim","family":"Yakoub\u2010Agha","sequence":"additional","affiliation":[{"name":"INSERM U1286 Centre Hospitalier Universitaire de Lille LIRIC  Lille France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,4,21]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrc3257"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737140.2019.1674142"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V67.5.1298.1298"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1611750"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1402888"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-020-04316-8"},{"key":"e_1_2_10_8_1","article-title":"Multiple myeloma: EHA\u2010ESMO clinical practice guidelines for diagnosis, treatment and follow\u2010up","volume":"5","author":"Dimopoulos MA","year":"2021","journal-title":"Ann Oncol"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41408-018-0155-7"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.34.9290"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2019.219295"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2017.178434"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.72.6679"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.17338"},{"key":"e_1_2_10_15_1","volume-title":"The EBMT Handbook: Hematopoietic Stem Cell Transplantation and Cellular Therapies, Multiple Myeloma","author":"Blad\u00e9 J","year":"2019"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2018.2961"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2019.219139"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2018-04-842880"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30687-9"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.39.6820"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25791"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2013.335"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)33003-4"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2019.07.004"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-021-01343-w"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-020-07732-1"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(21)00428-9"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31240-1"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020005288"}],"container-title":["European Journal of Haematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ejh.13981","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,30]],"date-time":"2023-12-30T21:09:01Z","timestamp":1703970541000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ejh.13981"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,21]]},"references-count":28,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1111\/ejh.13981"],"URL":"https:\/\/doi.org\/10.1111\/ejh.13981","archive":["Portico"],"relation":{},"ISSN":["0902-4441","1600-0609"],"issn-type":[{"value":"0902-4441","type":"print"},{"value":"1600-0609","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,21]]},"assertion":[{"value":"2023-02-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}