{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T04:48:46Z","timestamp":1785905326463,"version":"3.56.0"},"reference-count":31,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82000222"],"award-info":[{"award-number":["82000222"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"award":["82000222"],"award-info":[{"award-number":["82000222"]}],"id":[{"id":"https:\/\/ror.org\/01h0zpd94","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Shanxi Provincial Higher Education \u201cBillion Project\u201d Science and Technology Guidance Project","award":["BYJL051"],"award-info":[{"award-number":["BYJL051"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Extramedullary disease (EMD) in multiple myeloma (MM) is associated with poor prognosis, yet the clinical distinctions between bone-related EMD (bEMD) and soft tissue-associated EMD (sEMD) remain incompletely characterized. This study aimed to compare the clinical features and outcomes of bEMD versus sEMD and to develop a simple pre-treatment risk stratification tool using baseline clinical parameters. Methods: We retrospectively analyzed 118 patients with MM and EMD treated at a single center from 2011 to 2025, including 72 bEMD and 46 sEMD cases. Baseline characteristics, laboratory parameters, cytogenetic abnormalities, and survival outcomes were compared. Results: Patients with sEMD had significantly higher serum \u03b22-microglobulin (\u03b22-MG) levels (6.4 mg\/L vs. 4.5 mg\/L, p = 0.007) and a higher proportion of relapsed\/refractory disease (41.3% vs. 15.3%, p = 0.002) compared to bEMD. Median progression-free survival (PFS) and overall survival (OS) were markedly shorter in patients with sEMD than in those with bEMD (PFS: 12.0 vs. 29.0 months, p &lt; 0.001; OS: 25.0 vs. 67.0 months, p = 0.009). Multivariate analysis identified thrombocytopenia (PLT &lt; 100 \u00d7 109\/L), elevated \u03b22-MG, multisite extramedullary involvement, and TP53 deletion as independent adverse prognostic factors. A risk scoring system incorporating \u03b22-MG (0\u20132 points), thrombocytopenia (1 point), and multisite involvement (1 point) stratified patients into low-risk (0\u20132 points) and high-risk (3\u20134 points) groups with significantly different PFS (27.0 vs. 10.0 months, p &lt; 0.001) and OS (54.0 vs. 22.0 months, p = 0.008). Conclusions: sEMD represents a more aggressive subtype of MM with inferior outcomes. The proposed risk score, based on routinely available clinical parameters, effectively identifies high-risk patients at initial diagnosis and may guide individualized treatment strategies.<\/jats:p>","DOI":"10.3390\/cancers18152484","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T08:04:59Z","timestamp":1785744299000},"page":"2484","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Characteristics and Prognostic Analysis of Extramedullary Disease in Multiple Myeloma: A 15-Year Retrospective Cohort Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9768-3367","authenticated-orcid":false,"given":"Jingliang","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Hematology, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan 030000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2396-6369","authenticated-orcid":false,"given":"Qirui","family":"Bai","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan 030000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qile","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan 030000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaying","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan 030000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siyu","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan 030000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan 030000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan 030000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4747-1663","authenticated-orcid":false,"given":"Shengtao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan 030000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5421-5822","authenticated-orcid":false,"given":"Yanping","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan 030000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan 030000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqi","family":"Qin","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan 030000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"ref_1","unstructured":"Chinese Hematology Association, and Chinese Society of Hematology (2024). 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