[MYELOMA OR PLASMOCYTOMA].

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Abstract

[Indexed for MEDLINE] 10. Am J Hematol. 2026 Mar;101(3):521-536. doi: 10.1002/ajh.70138. Epub 2025 Dec 29. Extramedullary Disease-Achilles Heel in Myeloma? Kumar S(1), Richter J(2), Usmani SZ(3), Cohen YC(4)(5), Ye JC(6), Mateos MV(7), Hungria V(8), Zamagni E(9). Author information: (1)Mayo Clinic Rochester, Rochester, Minnesota, USA. (2)Mount Sinai School of Medicine, New York, New York, USA. (3)Memorial Sloan Kettering Cancer Center, New York, New York, USA. (4)Tel Aviv Sourasky (Ichilov) Medical Center, Tel Aviv, Israel. (5)Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel. (6)MD Anderson Cancer Center, University of Texas, Houston, Texas, USA. (7)Hospital of Salamanca/IBSAL/CIC/CIBERONC, Salamanca, Spain. (8)Clinica Médica São Germano, São Paulo, Brazil. (9)University of Bologna, Bologna, Italy. Despite advances in therapy, extramedullary disease (EMD) remains an aggressive form of multiple myeloma associated with poor outcomes. Patients with true EMD, in which plasmacytomas have become completely independent of bone, have a particularly poor prognosis. The pathogenesis of EMD is driven by complex mechanisms involving loss of adhesion molecules, heterogeneous genetic and epigenetic changes, and a solid tumor-like architecture within the microenvironment. Although the introduction of advanced imaging techniques and immunotherapy has led to improved detection and more promising outcomes and regimens, respectively, more prospective studies dedicated to true EMD are needed. © 2025 The Author(s). American Journal of Hematology published by Wiley Periodicals LLC. DOI: 10.1002/ajh.70138 PMCID: PMC12869003