Abstract: Objective  To investigate the clinical features and prognosis of patients with multiple myeloma (MM) who had extramedullary disease (EMD) at diagnosis. Methods  A total of 51 newly diagnozed MM patients who had EMD at diagnosis (including skeletalEMD and extraskeletalEMD) were retrospectively analyzed. The clinical features, EMD location, efficacy, survival and prognosis were explored. Results  The median followup was 44 months (ranged from 7 to 98 months). Patients in skeletalEMD group had  significantly higher percentage of osteolytic lesions ≥3(P=0.033), higher lymphocyte cells (P=0.016), and lower monocytetolymphocyte ratio (P=0.036) than that extraskeletalEMD group. The estimated overall survival(OS) of patients in extraskeletalEMD group was shorter than those  in skeletalEMD group (38 months vs not reached, P=0.056). Multivariate analysis showed that hemoglobin (HGB)＜118.8  g/L (OR=0.139, 95%CI=0.0400.488, P=0.002) was independently associated with inferior OS for the MM patients who had EMD at diagnosis. Conclusion  The prognosis in patients with MM who had EMD at diagnosis is poor. The patients in skeletalEMD group have better prognosis than those  in extraskeletalEMD group. Lower HGB is an independent factor for predicting inferior OS.

Key words: multiple myeloma, antineoplastic combined chemotherapy protocols, prognosis