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Published in: European Radiology 3/2015

01-03-2015 | Oncology

The application of Gadopentate-Dimeneglumin has no impact on progression free and overall survival as well as renal function in patients with monoclonal plasma cell disorders if general precautions are taken

Authors: J. Hillengass, J. Stoll, C. M. Zechmann, C. Kunz, B. Wagner, C. Heiss, M. Sumkauskaite, T. M. Moehler, H. P. Schlemmer, H. Goldschmidt, S. Delorme

Published in: European Radiology | Issue 3/2015

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Abstract

Objectives

The current analysis investigated the prognostic significance of gadopentetate dimeglumine on survival and renal function in patients with monoclonal plasma cell disorders.

Methods

In this study 263 patients who had received gadopentetate dimeglumine within a prospective trial investigating dynamic contrast-enhanced magnetic resonance imaging (MRI) were compared with 335 patients who had undergone routine, unenhanced MRI.

Results

We found no significant prognostic impact of the application of contrast agent on progression-free survival in patients with either monoclonal gammopathy of undetermined significance, smouldering or symptomatic myeloma and no significant prognostic impact on overall survival in patients with symptomatic myeloma. Since renal impairment is a frequent complication of myeloma, and decreased renal function is associated with a higher risk of complications in patients receiving contrast agents, we evaluated the impact of contrast agent on renal function after 1 year. In the present analysis the only significant adverse impact on kidney function occurred in symptomatic myeloma patients who already had impaired renal parameters at baseline. Here, the renal function did not recover during therapy, whereas it did so in patients with normal or only slightly impaired renal function.

Conclusion

If general recommendations are adhered to, gadopentetate dimeglumine can be safely applied in patients with monoclonal plasma cell disease.

Key Points

Application of gadopentetate dimeglumine has no adverse prognostic effect in plasma cell disorders
Renal function is not influenced by gadopentetate dimeglumine in asymptomatic myeloma patients
Adherence to general guidelines is sufficient in myeloma patients
Literature
1.
go back to reference Baur-Melnyk A, Buhmann S, Becker C, Schoenberg SO, Lang N, Bartl R et al (2008) Whole-body MRI versus whole-body MDCT for staging of multiple myeloma. AJR Am J Roentgenol 190:1097–1104CrossRefPubMed Baur-Melnyk A, Buhmann S, Becker C, Schoenberg SO, Lang N, Bartl R et al (2008) Whole-body MRI versus whole-body MDCT for staging of multiple myeloma. AJR Am J Roentgenol 190:1097–1104CrossRefPubMed
2.
go back to reference Zamagni E, Nanni C, Patriarca F, Englaro E, Castellucci P, Geatti O et al (2007) A prospective comparison of 18 F-fluorodeoxyglucose positron emission tomography-computed tomography, magnetic resonance imaging and whole-body planar radiographs in the assessment of bone disease in newly diagnosed multiple myeloma. Haematologica 92:50–55CrossRefPubMed Zamagni E, Nanni C, Patriarca F, Englaro E, Castellucci P, Geatti O et al (2007) A prospective comparison of 18 F-fluorodeoxyglucose positron emission tomography-computed tomography, magnetic resonance imaging and whole-body planar radiographs in the assessment of bone disease in newly diagnosed multiple myeloma. Haematologica 92:50–55CrossRefPubMed
3.
go back to reference Walker R, Barlogie B, Haessler J, Tricot G, Anaissie E, Shaughnessy JD Jr et al (2007) Magnetic resonance imaging in multiple myeloma: diagnostic and clinical implications. J Clin Oncol 25:1121–1128CrossRefPubMed Walker R, Barlogie B, Haessler J, Tricot G, Anaissie E, Shaughnessy JD Jr et al (2007) Magnetic resonance imaging in multiple myeloma: diagnostic and clinical implications. J Clin Oncol 25:1121–1128CrossRefPubMed
4.
go back to reference Hillengass J, Fechtner K, Weber MA, Bäuerle T, Ayyaz S, Heiss C et al (2010) Prognostic significance of focal lesions in whole-body magnetic resonance imaging in patients with asymptomatic multiple myeloma. J Clin Oncol 28:1606–1610CrossRefPubMed Hillengass J, Fechtner K, Weber MA, Bäuerle T, Ayyaz S, Heiss C et al (2010) Prognostic significance of focal lesions in whole-body magnetic resonance imaging in patients with asymptomatic multiple myeloma. J Clin Oncol 28:1606–1610CrossRefPubMed
5.
go back to reference Fulciniti M, Sundararaman S, Nanjappa P, Amin SB, Chevireddy P, Gokden N et al (2009) Gadolinium containing contrast agent promotes multiple myeloma cell growth: implication for clinical use of MRI in myeloma. Blood 114:1841CrossRef Fulciniti M, Sundararaman S, Nanjappa P, Amin SB, Chevireddy P, Gokden N et al (2009) Gadolinium containing contrast agent promotes multiple myeloma cell growth: implication for clinical use of MRI in myeloma. Blood 114:1841CrossRef
6.
go back to reference Kyle RA, Gertz MA, Witzig TE, Lust JA, Lacy MQ, Dispenzieri A et al (2003) Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clin Proc 78:21–33CrossRefPubMed Kyle RA, Gertz MA, Witzig TE, Lust JA, Lacy MQ, Dispenzieri A et al (2003) Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clin Proc 78:21–33CrossRefPubMed
7.
go back to reference Hillengass J, Zechmann C, Bäuerle T, Wagner-Gund B, Heiss C, Benner A et al (2009) Dynamic contrast-enhanced magnetic resonance imaging identifies a subgroup of patients with asymptomatic monoclonal plasma cell disease and pathologic microcirculation. Clin Cancer Res 15:3118–3125CrossRefPubMed Hillengass J, Zechmann C, Bäuerle T, Wagner-Gund B, Heiss C, Benner A et al (2009) Dynamic contrast-enhanced magnetic resonance imaging identifies a subgroup of patients with asymptomatic monoclonal plasma cell disease and pathologic microcirculation. Clin Cancer Res 15:3118–3125CrossRefPubMed
8.
go back to reference Grobner T (2006) Gadolinium–a specific trigger for the development of nephrogenic fibrosing dermopathy and nephrogenic systemic fibrosis? Nephrol Dial Transplant 21:1104–1108CrossRefPubMed Grobner T (2006) Gadolinium–a specific trigger for the development of nephrogenic fibrosing dermopathy and nephrogenic systemic fibrosis? Nephrol Dial Transplant 21:1104–1108CrossRefPubMed
9.
go back to reference Rosenbaum PR, Rubin DB (1983) The central role of the propensity score in observational studies for causal effects. Biometrika 70:41–55CrossRef Rosenbaum PR, Rubin DB (1983) The central role of the propensity score in observational studies for causal effects. Biometrika 70:41–55CrossRef
10.
go back to reference Schmoor C, Gall C, Stampf S, Graf E (2011) Correction of confounding bias in non-randomized studies by appropriate weighting. Biom J 53:369–387CrossRefPubMed Schmoor C, Gall C, Stampf S, Graf E (2011) Correction of confounding bias in non-randomized studies by appropriate weighting. Biom J 53:369–387CrossRefPubMed
11.
go back to reference Xie J, Liu C (2005) Adjusted Kaplan-Meier estimator and log-rank test with inverse probability of treatment weighting for survival data. Stat Med 24:3089–3110CrossRefPubMed Xie J, Liu C (2005) Adjusted Kaplan-Meier estimator and log-rank test with inverse probability of treatment weighting for survival data. Stat Med 24:3089–3110CrossRefPubMed
12.
go back to reference Lee BK, LesslerJ SEA (2011) Weight trimming and propensity score weighting. PLoS One 6:1–6 Lee BK, LesslerJ SEA (2011) Weight trimming and propensity score weighting. PLoS One 6:1–6
13.
go back to reference Mitra R, Reiter JP (2012) A comparison of two methods of estimating propensity scores after multiple imputation. Stat Methods Med Res(Jun 11) Mitra R, Reiter JP (2012) A comparison of two methods of estimating propensity scores after multiple imputation. Stat Methods Med Res(Jun 11)
15.
go back to reference Lumley T (2004) Analysis of complex survey samples. J Stat Softw 9:1–19 Lumley T (2004) Analysis of complex survey samples. J Stat Softw 9:1–19
17.
go back to reference Scheid C, Sonneveld P, Schmidt-Wolf IG, van der Holt B, Jarari LE, Bertsch U et al (2014) Bortezomib before and after autologous stem cell transplantation overcomes the negative prognostic impact of renal impairment in newly diagnosed multiple myeloma: a subgroup analysis from the HOVON-65/GMMG-HD4 trial. Haematologica 99:148–154CrossRefPubMedCentralPubMed Scheid C, Sonneveld P, Schmidt-Wolf IG, van der Holt B, Jarari LE, Bertsch U et al (2014) Bortezomib before and after autologous stem cell transplantation overcomes the negative prognostic impact of renal impairment in newly diagnosed multiple myeloma: a subgroup analysis from the HOVON-65/GMMG-HD4 trial. Haematologica 99:148–154CrossRefPubMedCentralPubMed
18.
go back to reference Spinnato P, Bazzocchi A, Brioli A, Nanni C, Zamagni E, Albisinni U et al (2012) Contrast enhanced MRI and 18 F-FDG PET-CT in the assessment of multiple myeloma: a comparison of results in different phases of the disease. Eur J Radiol 81:4013–4018CrossRefPubMed Spinnato P, Bazzocchi A, Brioli A, Nanni C, Zamagni E, Albisinni U et al (2012) Contrast enhanced MRI and 18 F-FDG PET-CT in the assessment of multiple myeloma: a comparison of results in different phases of the disease. Eur J Radiol 81:4013–4018CrossRefPubMed
19.
go back to reference EMA (2009) European Medicines Agency makes recommendations to minimise risk of nephrogenic systemic fibrosis with gadolinium-containing contrast agents. Press release EMEA/CHMP/739818/2009 EMA (2009) European Medicines Agency makes recommendations to minimise risk of nephrogenic systemic fibrosis with gadolinium-containing contrast agents. Press release EMEA/CHMP/739818/2009
20.
go back to reference Sadowski EA, Bennett LK, Chan MR, Wentland AL, Garrett AL, Garrett RW et al (2007) Nephrogenic systemic fibrosis: risk factors and incidence estimation. Radiology 243:148–157CrossRefPubMed Sadowski EA, Bennett LK, Chan MR, Wentland AL, Garrett AL, Garrett RW et al (2007) Nephrogenic systemic fibrosis: risk factors and incidence estimation. Radiology 243:148–157CrossRefPubMed
21.
go back to reference Schneeberger D, Tyndall A, Kay J, Søndergaard KH, Carreira PE, Morgiel E et al (2013) Systemic sclerosis without antinuclear antibodies or Raynaud's phenomenon: a multicentre study in the prospective EULAR Scleroderma Trials and Research (EUSTAR) database. Rheumatology (Oxford) 52:560–567CrossRef Schneeberger D, Tyndall A, Kay J, Søndergaard KH, Carreira PE, Morgiel E et al (2013) Systemic sclerosis without antinuclear antibodies or Raynaud's phenomenon: a multicentre study in the prospective EULAR Scleroderma Trials and Research (EUSTAR) database. Rheumatology (Oxford) 52:560–567CrossRef
Metadata
Title
The application of Gadopentate-Dimeneglumin has no impact on progression free and overall survival as well as renal function in patients with monoclonal plasma cell disorders if general precautions are taken
Authors
J. Hillengass
J. Stoll
C. M. Zechmann
C. Kunz
B. Wagner
C. Heiss
M. Sumkauskaite
T. M. Moehler
H. P. Schlemmer
H. Goldschmidt
S. Delorme
Publication date
01-03-2015
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 3/2015
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3458-5

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