Treatment Patterns And Survival Outcomes Of Multiple Myeloma-Associated Pericardial Effusion And Cardiac Tamponade

Abstract

Pericardial effusion and cardiac tamponade are rare and life-threatening complications associated with multiple myeloma that usually indicate advanced or extramedullary disease and should be treated urgently in the acute setting. Although most patients have a poor prognosis, there are few data on treatment patterns and survival since most published data derives from isolated case reports. To assess the demographic characteristics, prior treatment experience, treatment modalities, survival and mortality in a publically available database of 28 patients with MM-associated PE and cardiac tamponade. The descriptive statistical analysis showed that the mean age of the patient was 61.5 years and a slight male predominance. Prior chemotherapy was received by most of the patients before the development of pericardial complications. Pericardiocentesis was the most common therapeutic procedure used, while corticosteroids, further chemotherapy, pericardial window creation and intrapericardial therapy was performed in some instances. The median survival was 17 weeks, reflecting poor prognosis for cardiac involvement in MM. These data highlight the need to recognize the condition promptly, to establish rapid hemodynamic stability and to manage the patient's hematology individually to optimize the outcome. Larger multicenter studies are needed to define management guidelines and increase survival for this uncommon but clinically important complication.