Bone Marrow Transplantation in Patients with Multiple Myeloma
Prognostic Significance of MR Imaging
Frederic E. Lecouvet1,
Stephane Dechambre1,
Jacques Malghem1,
Augustin Ferrant2,
Bruno C. Vande Berg1 and
Baudouin Maldague1
1
Department of Radiology and Medical Imaging, UCL 10/2942, Saint Luc University
Hospital, Université Catholique de Louvain,
Hippocrate Ave., 10, B1200 Brussels, Belgium
2
Department of Hematology, Saint Luc University Hospital,
Université Catholique de Louvain, Brussels,
Belgium.
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Fig. 1A. —52-year-old man with multiple myeloma. Pretransplantation
sagittal T1-weighted spin-echo MR image (400/20, TR/TE) shows large focal area
of low signal intensity in T5-vertebral body.
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Fig. 1B. —52-year-old man with multiple myeloma. Contrast-enhanced
T1-weighted MR image shows diffuse lesion enhancement.
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Fig. 1C. —52-year-old man with multiple myeloma. Posttransplantation MR
images obtained before (C) and after (D) contrast material
injection show reduction in lesion size and contrast enhancement.
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Fig. 1D. —52-year-old man with multiple myeloma. Posttransplantation MR
images obtained before (C) and after (D) contrast material
injection show reduction in lesion size and contrast enhancement.
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Fig. 2A. —56-year-old man with multiple myeloma. Coronal T1-weighted
spin-echo MR image before transplantation shows numerous focal areas of low
signal intensity in both femoral necks and acetabular roofs.
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Fig. 2B. —56-year-old man with multiple myeloma. Corresponding MR image
after transplantation shows that foci have disappeared.
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Fig. 3A. —50-year-old man with multiple myeloma. Sagittal T1-weighted
spin-echo MR image of lumbar spine before transplantation shows abnormal
diffuse low signal intensity in vertebral bodies.
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Fig. 3B. —50-year-old man with multiple myeloma. Corresponding MR image
after transplantation shows conversion to normal high-signal-intensity
marrow.
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Fig. 4. —Graph shows Kaplan-Meier estimation of overall survival in 25
multiple myeloma patients treated with high-dose cytotoxic chemotherapy and
bone marrow transplantation, according to marrow evolution index (MEI)
obtained by comparison of MR images before and after treatment (p =
0.005). Cut-off value of 4 was chosen (solid line, MEI < 4;
dotted line, MEI  4).
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Fig. 5. —Graph shows Kaplan-Meier estimation of relapse-free survival
in 25 multiple myeloma patients treated with high-dose cytotoxic chemotherapy
and bone marrow transplantation according to marrow evolution index (MEI)
obtained by comparison of MR images before and after treatment (p
< 0.001). Cut-off value of 4 was chosen (solid line, MEI < 4;
dotted line, MEI 4).
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Fig. 6. —Graph shows Kaplan-Meier estimation of relapse-free survival
in 25 multiple myeloma patients treated with high-dose cytotoxic chemotherapy
and bone marrow transplantation according to serum
ß2-microglobulin levels before treatment (p = 0.004).
Cut-off value of 3.0 mg/dL was chosen (solid line,
ß2-microglobulin level < 3.0 mg/dL; dotted line,
ß2-microglobulin level 3.0 mg/dL).
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Copyright © 2001 by the American Roentgen Ray Society.
