Myeloma of the central nervous system: report of a single center case series

Background: Neurologic manifestations often complicate the course of multiple myeloma, but direct involvement of the central nervous system (CNS) is rare. Objective: To describe the clinical course, neurological symptoms, laboratory findings and imaging of patients with CNS myeloma. This additional information may contribute to better recognition and more effective management of this complication in the future. Methods: We retrospectively identified 6 MM patients with CNS involvement diagnosed at our centre between April 2003 and April 2009. The clinical, biochemical and imaging data were collected and compared with previously reported cases. Results: At time of diagnosis of CNS myeloma, 3 patients had progressive disease and 3 were in good partial remission. The presenting symptoms included diplopia, vision loss, extremity weakness and paresis. All cases showed one or more features of aggressive disease at diagnosis, including high tumour burden, plasmablastic morphology and high-risk cytogenetic abnormalities. Prognosis was poor with a median survival of 4.8 months. Conclusion: CNS myeloma should be considered in patients with aggressive MM and unexplained neurological symptoms. The prognosis is poor despite intensive therapy