The Korean Journal of Internal Medicine Vol. 29, No. 5 (Suppl. 1)
WCIM 2014 SEOUL KOREA 355
Poster Session
Methods: Data from patients at thirteen university hospitals in South Korea between December 2005 and May 2013 were collected retrospectively. All included patients were treated with thalidomide containing chemotherapy and then underwent ASCT.
The infl ammatory score was defi ned that each infl ammatory parameters including ALC level under 1000/μL, Serum B2MG level above 3.5 mg/L Serum albumin under 3.5 g/dL and LDH above 450 IU/L were scored 1 point and sum of those were used infl amma- tory scores such as 0 to 4 points.
Results: In the multivariate analysis, Infl ammatory score (<2) was only independent prognostic factor for superior PFS (RR;0.618, 95% C.I. 0.409-0.933, p=0.022) and platelet counts of more than 100×109/L, infl ammatory score of less than 2 were inde- pendent prognostic factors for superior OS (RR 7.856, 95% C.I. 2.502-24.670, p<0.001 and RR 0.216, 95% C.I. 0.067-0.696, p=0.010, respectively).
Conclusions: Patients combined many infl ammatory factors who treated with thalid- omide induction chemotherapy underwent ASCT were shown signifi cant short survival and these results might be helped to predict prognosis.
PS 1398 Hemato-Oncology (Hematology) Successful Treatment by Corticosteroid of Postopera- tive Remnant intraorbital Castleman’s Disease
Yun Mi Kwak1, SB Bae1, DH Inn1, HZ Kim1, SC Lee1, KT Lee1, JK Han1, HD Cho1 Soon Chun Hyang University Hospital Cheonan, Korea1
Castleman’s disease(CD) is a rare atypical lymphoproliferative disorder of uncertain etiology that mainly develops in the lymph nodes and has been classifi ed, based on clinical presentation and histopathology, into two clinical entities (unicentric and mul- ticentric form) and three pathological type(hyaline-vascular, plasma cell, and mixed cell type), respectively. Castleman’s disease involving the orbit is an extremely rare occurrence that may present initially with ocular signs and symptoms. A 52-years- old man has complained with palpable Lt orbital mass 7 days ago. He had no specifi c history of medication or family history of illness. He had no other constitutional symptoms, such as high fever, night sweats, and weight loss. Physical examination did not show hepatosplenomegaly and lymphadenopathy. Opthalmologic examination revealed movable, non-tender, smooth-surfaced round mass in the Lt anterior inferior aspect. Orbital CT showed homogenously 11x11mm sized irregular enhanced mass of anterior inferior portion at Lt orbit. The patient underwent anterior orbitotomy with surgical excision. Histopathologic examination of Lt anterior orbital mass confi rmed the presence of Castleman’s disease, hyaline vascular type, and pathologic margin was involved. Additional surgical operation was diffi cult, because of risk of Lt corneal injury. We planned closed observation and follow up. MRI fi nding at 2 months after surgical excision revealed 6x6mm sized round homogenous enhanced mass at the Lt anterior orbital space. Our patient was treated with systemic corticosteroid(tapering schedule), demonstrating marked improvement of follow up MRI fi ndings. He has re- ceived corticosteroid for 9 months and stopped it. At 28 months after discontinuation, he is still asymptomatic with no evidence of disease recurrence. We experienced a rare case of Castleman’s disease involving the orbit, and achieved successful treatment by corticosteroid of postoperative remnant Intraorbital Castleman’s Disease.
PS 1399 Hemato-Oncology (Hematology) Response to Induction Treatment Adapted Selection of Mobilization Regimen in Multiple Myeloma: The G-CSF Alone Versus High-Dose Cyclophosphamide Plus G-CSF Regimen
Jung Yeon Lee1, Ji Eun Jang1, Soo Jeong Kim1, Chelwon Suh2, Hyewon Lee3, Ho-Young Yhim4, Won Sik Lee5, Chang-Ki Min6, Jae Hoon Lee7, Joon Seong Park8, Jin Seok Kim1 Severance Hospital, Korea1, Asan Medical Center, Korea2, National Cancer Center, Korea3, Chonbuk National University Hospital, Korea4, Busan Paik Hospital, Korea5, Seoul St. Mary’s Hospital, Korea6, Gachon University Gil Hospital, Korea7, Ajou University School of Medicine, Korea8
Background: The optimal method for mobilizing stem cells for autologous stem cell transplantation (ASCT) in multiple myeloma remains unclear. There is no guideline for choice of mobilizing regimen although both of G-CSF alone regimen and cyclophos- phamide plus G-CSF regimens are recommended by International myeloma working group and used most commonly.
Methods: A total of 179 patients who diagnosed with MM were admitted for PBSC mobilization using cyclophosphamide plus G-CSF or G-CSF alone between Sep. 2006 and Apr. 2013 from 8 institutions in Korea were analyzed retrospectively. The patients (N=62) who received G-CSF alone for mobilization in complete response (CR) or very good partial response (VGPR) status and the patients (N=65) who received HD-CY+G-CSF for mobili- zation in response less than VGPR were classed as the ‘Response adapted group’ (N=127).
Results: In patients mobilized by HD-CY+G-CSF, the percentage of plasma cell in bone marrow at mobilization was signifi cantly higher (4.0% vs. 0.7%, P<0.001). The total quantities of CD34+ cells collected per patients were 6.6 x10^6/kg in G-CSF group and 12.7 x10^6/kg in CY group (P<0.001). The rate of successful mobilization tend to be higher in CY group but had no statistical difference (79% and 91%, P=0.064). Dura- tion of hospitalization for PBSC mobilization was longer in CY group (9days vs. 17days, P<0.001) and the treatment-related toxicity was greater in this group. Median time to neutrophil engraftment was 10 days for G-CSF alone and 11 days for HD-CY+G-CSF (P=0.004) despite the quantities of infused CD34+ cells were higher in CY group than G-CSF group (6.2 x 10^6/kg vs. 4.5 x 10^6/kg, P < 0.001).
Conclusions: The risk adapted choice for mobilization with G-CSF alone is preferred in the MM patients who achieve a good response to induction treatment.
PS 1400 Hemato-Oncology (Hematology) The Impact of Oliguria in Patients with Multiple Mye- loma Presenting with Renal Impairment
Seo-Yeon Ahn1, Sung-Hoon Jung1, Jae-Sook Ahn1, Deok-Hwan Yang1, Min-Seok Cho1, Yeo-Kyeoung Kim1, Hyeoung-Joon Kim1, Je-Jung Lee1
Chonnam National University Hwasun Hospital, Korea1
Background: Recently, change of urine output is valuable biomarker of acute kidney injury associated with mortality in critically ill patients. This study investigated the prognostic impact of oliguria for survival outcomes in patients with multiple myeloma (MM) presenting with renal impairment (RI).
Methods: Retrospective data for 98 patients with MM and RI who were treated up- front with a novel agent containing regimen were analyzed. Oliguria was defi ned as a urine output that is less than 0.5ml/kg/hours.
Results: Baseline median eGFR was 39.7 ml/min (range 5.1-59.8). Achievement of renal complete response (renalCR) was observed in 39.8% of patients. Nine patients (9.2%) presented with oliguria at initial diagnosis, and four initially required dialysis.
Over follow-up for a median of 17.1 (range 1.7-100.0) months and median OS was 38.7 months (95% CI 25.0-52.5). On multivariate analysis, oliguria at diagnosis (hazard ratio [HR] 3628, 95% CI 1.366-9.849, P = 0.011) and thrombocytopenia < 100ⅹ 109/
L (HR 2.534, 95% CI 1.068-6.015, P = 0.035) at diagnosis were signifi cantly associated with overall survival.
Conclusions: Oliguria was signifi cantly associated with high mortality in MM patients with RI. Therefore, close monitoring of urine output could be important in MM pa- tients with RI.