Clinical Features, Therapeutic Interventions, and Prognostic Outcomes of Plasma Cell-Associated Pericardial Disease in Multiple Myeloma

Abstract

Extramedullary involvement of multiple myeloma (MM) in the form of plasma cell-associated pericardial disease is a rare, but potentially fatal complication that is often associated with cardiac tamponade or pericardial effusion. Due to its rarity, there was a lack of comprehensive knowledge regarding the clinical presentation, management and prognosis, with just isolated case reports available. In this study, the clinical characteristics, therapeutic choices, and survival of patients with plasma cell-associated pericardial disease were assessed through individual patient data analysis. A retrospective study was performed in 28 patients with known involvement of the pericardium due to MM. Data for demographics, clinical, therapeutic and outcome was extracted and analysed descriptively. The majority of patients had advanced or relapsed/recurrent multiple myeloma and a symptomatic pericardial effusion that required urgent intervention. Pericardiocentesis was the most common procedure performed and systemic chemotherapy and corticosteroids were the most common treatment strategy. Even with multimodal management, prognosis was still poor, and most deaths were due to disease progression. These findings reinforce the aggressive nature of the plasma cell associated pericardial disease and the need for recognition of early disease, rapid pericardial drainage, and multidisciplinary management. More large-scale multi-center studies are needed to develop a standardized diagnosis and treatment protocol and to enhance clinical results.