Journal article
Beyond the CRAB Symptoms: A Study of Presenting Clinical Manifestations of Multiple Myeloma
Clinical lymphoma, myeloma and leukemia, Vol.10(6), pp.464-468
12/2010
DOI: 10.3816/CLML.2010.n.080
PMID: 21156463
Abstract
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.
We conducted a retrospective review of 170 consecutive patients with MM seen at the Penn State Hershey Cancer Institute.
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.
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.
Details
- Title: Subtitle
- Beyond the CRAB Symptoms: A Study of Presenting Clinical Manifestations of Multiple Myeloma
- Creators
- Giampaolo Talamo - Penn State Hershey Cancer Institute, Hershey, PAUmar Farooq - Department of Medicine, Harrisburg Hospital-Pinnacle Health System, Harrisburg, PAMaurizio Zangari - Division of Hematology, Blood/Marrow Transplant and Myeloma Program, University of Utah, Salt Lake City, UTJason Liao - Penn State Hershey Cancer Institute, Hershey, PANathan G Dolloff - Penn State Hershey Cancer Institute, Hershey, PAThomas P Loughran - Penn State Hershey Cancer Institute, Hershey, PAElliot Epner - Penn State Hershey Cancer Institute, Hershey, PA
- Resource Type
- Journal article
- Publication Details
- Clinical lymphoma, myeloma and leukemia, Vol.10(6), pp.464-468
- Publisher
- Elsevier Inc
- DOI
- 10.3816/CLML.2010.n.080
- PMID
- 21156463
- ISSN
- 2152-2650
- eISSN
- 2152-2669
- Language
- English
- Date published
- 12/2010
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984094386802771
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