| Beyond the CRAB Symptoms: A Study of Presenting Clinical Manifestations of Multiple Myeloma. | |
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MedLine Citation:
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PMID: 21156463 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Background: Although the typical clinical manifestations of multiple myeloma (MM) are summarized by the CRAB symptoms (hypercalcemia, renal insufficiency, anemia, and bone lesions), a significant proportion of patients with MM present with a variety of other clinical manifestations. We conducted a study evaluating the presenting symptoms that led to the diagnosis of MM. Patients and Methods: We conducted a retrospective review of 170 consecutive patients with MM seen at the Penn State Hershey Cancer Institute. Results: Among patients with symptomatic MM, 74% presented with CRAB symptoms, 20% presented with non-CRAB manifestations, and 6% had both clinical features. Ten categories of non-CRAB manifestations were found, in order of decreasing frequency: neuropathy (because of spinal cord compression, nerve root compression, or peripheral neuropathy), extramedullary involvement, hyperviscosity syndrome, concomitant amyloidosis (eg, nephrotic syndrome or cardiopathy), hemorrhage/coagulopathy, systemic symptoms (eg, fever or weight loss), primary plasma cell leukemia, infections, cryoglobulinemia, and secondary gout. Kaplan-Meier estimates of survival in patients with non-CRAB manifestations did not show a significant difference from the survival of patients presenting with CRAB symptoms. Conclusion: Presenting symptoms of MM may be grouped in a total of 14 categories, 4 for the CRAB and 10 for the less common non-CRAB features. Grouped together, non-CRAB manifestations do not appear to confer a negative effect on the prognosis of patients with MM. |
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Authors:
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Giampaolo Talamo; Umar Farooq; Maurizio Zangari; Jason Liao; Nathan G Dolloff; Thomas P Loughran; Elliot Epner |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinical lymphoma, myeloma & leukemia Volume: 10 ISSN: 2152-2669 ISO Abbreviation: Clin Lymphoma Myeloma Leuk Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-12-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101525386 Medline TA: Clin Lymphoma Myeloma Leuk Country: United States |
Other Details:
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Languages: eng Pagination: 464-8 Citation Subset: IM |
Affiliation:
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Penn State Hershey Cancer Institute, Hershey, PA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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