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Impact of CRAB symptoms in survival of patients with symptomatic myeloma in novel agent era

Aya Nakaya, Shinya Fujita, Atsushi Satake, Takahisa Nakanishi, Yoshiko Azuma, Yukie Tsubokura, Masaaki Hotta, Hideaki Yoshimura, Kazuyoshi Ishii, Tomoki Ito, Shosaku Nomura
  • Aya Nakaya
    First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan | nakaya1016@yahoo.co.jp
  • Shinya Fujita
    First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan
  • Atsushi Satake
    First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan
  • Takahisa Nakanishi
    First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan
  • Yoshiko Azuma
    First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan
  • Yukie Tsubokura
    First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan
  • Masaaki Hotta
    First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan
  • Hideaki Yoshimura
    First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan
  • Kazuyoshi Ishii
    First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan
  • Tomoki Ito
    First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan
  • Shosaku Nomura
    First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan

Abstract

The acronym CRAB summarizes the most typical clinical manifestations of multiple myeloma, these being hypercalcemia, renal failure, anemia, and bone disease. CRAB can be used to distinguish between active, symptomatic multiple myeloma and monoclonal gammopathy of undermined significance or smoldering myeloma. The distinction is relevant not only for classification and diagnosis but also for therapy. CRAB factors influence the prognosis of multiple myeloma. However, it is unclear whether the presence of CRAB factors has an influence on the prognosis of myeloma treated with novel agents. In the current study, patients with hypercalcemia and bone disease showed a significantly worse prognosis, whereas anemia and renal failure showed no difference in survival. Novel agents used for treatment of patients with renal failure suggested a favorable outcome compared with conventional therapy. Bone disease was the most common factor and may have the strongest prognostic value in symptomatic myeloma patients using novel agents.

Keywords

CRAB; symptomatic myeloma; novel agent; conventional therapy

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Submitted: 2016-09-14 08:29:43
Published: 2017-02-23 11:37:00
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Copyright (c) 2017 Aya Nakaya, Shinya Fujita, Atsushi Satake, Takahisa Nakanishi, Yoshiko Azuma, Yukie Tsubokura, Masaaki Hotta, Hideaki Yoshimura, Kazuyoshi Ishii, Tomoki Ito, Shosaku Nomura

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