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iwHRMM 2025 | Differences between extramedullary disease and paraskeletal disease in multiple myeloma
Saurabh Zanwar, MD, MBBS, Mayo Clinic, Rochester, MN, discusses the differences between extramedullary disease and paraskeletal disease in multiple myeloma. He highlights that while there is no unique mutation distinguishing these entities, genomic data suggests distinct biological differences between them. This interview took place at the 2nd International Workshop on High-Risk Multiple Myeloma (iwHRMM 2025), held in Charleston, SC.
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Transcript
For the longest time we have kind of clumped these entities together but we are starting to parse out the differences in outcomes between extramedullary disease which is distinct from the bone marrow milieu versus paraskeletal disease which is originating more from the bone itself. In terms of a biologic difference there’s not a whole lot of data out there. The genomic data that we see shows us that extramedullary disease is much more genomically complex compared to paraskeletal disease...
For the longest time we have kind of clumped these entities together but we are starting to parse out the differences in outcomes between extramedullary disease which is distinct from the bone marrow milieu versus paraskeletal disease which is originating more from the bone itself. In terms of a biologic difference there’s not a whole lot of data out there. The genomic data that we see shows us that extramedullary disease is much more genomically complex compared to paraskeletal disease. There’s no smoking gun in terms of a unique mutation in these entities. The chromosomal aberrations also appear to be more on lines with what we would expect with relapsed refractory disease, just more pronounced in extramedullary disease compared to paraskeletal disease.
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