Poster Presentations: Wednesday, October 26, 2011 |

Characteristics and Clinical Significance of Pleural Effusions in Patients With Multiple Myeloma (MM) FREE TO VIEW

Mark Warner, MD; Lara Bashoura, MBBS; George Eapen, MBBS; Carlos Jimenez, MD; Rodolfo Morice, MD; Saadia Faiz, MD
Chest. 2011;140(4_MeetingAbstracts):701A. doi:10.1378/chest.1119785
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PURPOSE: Pleural effusions in MM are rare, and malignant effusions signify poor prognosis. Our purpose is to characterize pleural effusions of all etiologies and to define their impact on survival.

METHODS: Patients with MM who underwent thoracenteses from January 1997 to December 2010 were identified. Clinical history and laboratory data were reviewed retrospectively.

RESULTS: Forty-seven patients (M=24, F=23) had a pleural procedure. IgG myeloma (n=25) was the most common isotype. Amyloidosis was present in 6 patients, and 15 patients had plasmacytoma. Disease status varied from active (n=38), presentation (n=3), remission (n=2), and post-hematopoietic stem cell transplant (n=4). Most procedures were unilateral, but 6 patients required bilateral pleural interventions. Multiple pleural procedures were required in 24 patients. Two pleural biopsies, 11 chest tubes, 16 pleural catheters, and 63 thoracenteses were performed. Twenty-four patients had exudative effusions, and 19 patients had transudative effusions. Etiologies of the pleural effusions included malignancy (n=18), volume (n=18), infection (n=10) and other (n=1). Pleural biopsies revealed multiple myeloma and inflammation in two patients respectively. There were 2 complications associated with pleural catheters (empyema, catheter occlusion). Nine patients remain alive, of which 2 had malignant effusions. In the remainder of patients, median survival from time of diagnosis to death was 38 months (0.2-98), and median survival from time of pleural effusion to death was 6.5 months (0.03-75).

CONCLUSIONS: Pleural procedures in MM patients may significantly impact clinical management, since the cause of these effusions, including infection, volume overload, and disease, may be easily identified.

CLINICAL IMPLICATIONS: Pleural procedures are safe and informative in MM patients. Further evaluation with pleural biopsy for effusions of unclear etiology may provide definitive diagnosis.

DISCLOSURE: The following authors have nothing to disclose: Mark Warner, Lara Bashoura, George Eapen, Carlos Jimenez, Rodolfo Morice, Saadia Faiz

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