Oncologic Progression of Bone Plasmacytomas to Multiple Myeloma

Abstract

PURPOSE: To evaluate the clinical aspects, diagnoses, prognostic factors, and percent progression of plasmacytoma to multiple myeloma. MATERIALS AND METHODS: 103 medical records of patients suspected of plasmacytoma were surveyed covering the period between 1950 and 1998, and 30 were selected for analysis. Patients were classified into 2 groups: patients who did (n = 17) and did not (n = 13) progress to multiple myeloma. Comparative statistics regarding a variety of clincial aspects were developed. RESULTS: Patients who progressed to multiple myeloma were younger than those who did not (52.3 ± 2.6 vs 62.6 ± 3.4 years; mean ± SEM; P = 0.02). There were no significant differences in gender between groups. A higher incidence of multiple recurrence was observed in patients who progressed to multiple myeloma (75%, P = 0.049). Both groups showed a prevalence of vertebral column injuries. No significant differences were found between groups regarding the disease period (from the onset of symptoms until diagnosis) (P = 0.20) and survival (P = 0.34). The average time to progression from plasmacytoma to myeloma was 41 ± 39 months (mean ± SD), and the progression rate was 57%. CONCLUSION: Patients who progressed to multiple myeloma were younger than those who did not. No significant differences were found between groups regarding sex, time from symptom onset to diagnosis, and survival time. In both groups, the most affected anatomic location was the vertebral column, and most affected sex was male. The average time to progression to multiple myeloma was 41 months. It was not possible to determine the factors that influenced the survival of patients with plasmacytoma or for those who progressed to multiple myeloma.

Risk factors for progression of solitary plasmacytoma of bone to multiple myeloma in the spine: A population-based study

“…However, Bertanha et al, found that patients who progressed to MM were younger than those who did not. In their study, the average time of progression to MM was 41 months [9]. However, the evidence of the risk factor analysis was low because the small sample size of the two groups was only compared using the t test analysis.…”

Surgical Approach of Cauda Equina Syndrome Secondary to L5 Lumbar Solitary Bone Plasmocytoma with Partial Resection and Lumbopelvic Fixation

“…3 The solitary bone plasmacytoma represents a 10-year survival rate up to 85% patients 6 ; however, 50% can progress to a MM variant, with worse prognosis. 7 The diagnosis work-up should include a complete anamnesis, physical examination, laboratory studies, tumor histopathology confirmation, protein electrophoresis, and evaluation for the presence of Bence Jones protein (Ig light chains in urine). 5 In solitary bone plasmacytoma, the symptoms depend on the localization of the lesion and could be from lumbar pain with radicular signs to sphincter compromise.…”

Plasmocitoma solitario de esternón: presentación de un caso y revisión de la literatura

“…Por otro lado, numerosos equipos prefieren la radioterapia como primera opción, incluso en los casos en que la resección ha sido efectuada por falta de diagnóstico, refiriendo buena respuesta en más del 90% de los casos [11][12][13][14] .…”

“…La quimioterapia parece no brindar claros beneficios en supervivencia ni en prevención de la progresión a Mieloma Múltiple 3,12,14 . Esta progresión, ocurre más frecuentemente dentro de los cuatro primeros años, con un promedio de 41 meses.…”