Multiparameter flow cytometry for staging of solitary bone plasmacytoma: new criteria for risk of progression to myeloma

Paiva, Bruno; Chandía, Mauricio; Vidriales, María‐Belén; Colado, Enrique; Caballero‐Velázquez, Teresa; Escalante, Fernando; Coca, Alfonso García de; Montes, Maria-Carmen; García‐Sanz, Ramón; Ocio, Enrique M.; Mateos, María‐Victoria; Miguel, Jesús F. San

doi:10.1182/blood-2014-04-567909

Cited by 66 publications

(55 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus, we believe dose escalation is only potentially beneficial, requiring for evidence from well-designed studies. On the other hand, risk factors for MM are: serum β2 microglobulin≥3.5 mg/L (Guo et al, 2013), bone invasion (Ozsahin et al, 2006), involvement of axial bone (Bataille et al, 1981), age (Tournier-Rangeard et al, 2006), monoclonal urinary light chains (Hill et al, 2014) and positive multiparameter flow cytometry (Paiva et al, 2014). Reported by Huang et al, in patients with SP of cervical spine, adjunctive RT following excision obviously decreased MM progression (Huang et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Radiotherapy Alone is Associated with Improved Outcomes Over Surgery in the Management of Solitary Plasmacytoma

Li¹,

Niu²,

Wang³

et al. 2015

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

Background: A moderate dose of radiation is the recommended treatment for solitary plasmacytoma (SP), but there is controversy over the role of surgery. Our study aimed at comparing different treatment modalities in the management of SP. Materials and Methods: Data from 38 consecutive patients with solitary plasmacytoma, including 16 with bone plasmacytoma and 22 with extramedullary plasmacytoma, were retrospectively reviewed. 15 patients received radiotherapy alone; 11 received surgery alone, and 12 received both. The median radiation dose was 50Gy. All operations were performed as radical resections. Local progression-free survival (LPFS), multiple myeloma-free survival (MMFS), progression-free survival (PFS) and overall survival (OS) were calculated and outcomes of different therapies were compared. Results: The median follow-up time was 55 months. 5-year LPFS, MMFS, PFS and OS were 87.0%, 80.9%, 69.8% and 87.4%, respectively. Univariate analysis revealed, compared with surgery alone, radiotherapy alone was associated with significantly higher 5-year LPFS (100% vs 69.3%, p=0.016), MMFS (100% vs 51.4%, p=0.006), PFS (100% vs 33.7%, p=0.0004) and OS (100% vs 70%, p=0.041). Conclusions: Radiotherapy alone can be considered as a more effective treatment for SP over surgery. Whether a combination of radiotherapy and surgery improves outcomes requires further study.

show abstract

Section: Discussionmentioning

confidence: 99%

Radiotherapy Alone is Associated with Improved Outcomes Over Surgery in the Management of Solitary Plasmacytoma

Li¹,

Niu²,

Wang³

et al. 2015

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

show abstract

“…The prognosis of solitary plasmacytoma varies depending on presence of clonal plasma cells in the bone marrow. [12][13][14][15][16] It therefore consists of two distinct entities: solitary plasmacytoma (no clonal BMPCs) and solitary plasmacytoma with low marrow involvement (<10% clonal BMPCs). By contrast, patients with solitary plasmacytoma and 10% or more of clonal plasma cells are classifi ed as multiple myeloma.…”

Section: Other Specifi C Disease Statesmentioning

confidence: 99%

“…[5][6][7][8][9] The diagnosis of MGUS requires the absence of hypercalcaemia, renal failure, anaemia, and bone lesions (referred to as CRAB features) that can be attributed to the underlying plasma cell disorder (all features must be absent; table 1). [10][11][12][13][14][15][16][17][18][19][20] About 80% of multiple myeloma originates from non-IgM immunoglobulin MGUS (nonIgM MGUS), and 20% from light-chain immunoglobulin MGUS (LC-MGUS). In the event of progression, IgM immunoglobulin MGUS (IgM MGUS) usually evolves into Waldenström macroglobulinaemia, but in rare instances IgM MGUS can progress to multiple myeloma (IgM myeloma).…”

Section: Introductionmentioning

confidence: 99%

International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma

Rajkumar

Dimopoulos

Palumbo

et al. 2014

The Lancet Oncology

Self Cite

3,469

2,996

View full text Add to dashboard Cite

This International Myeloma Working Group consensus updates the disease defi nition of multiple myeloma to include validated biomarkers in addition to existing requirements of attributable CRAB features (hypercalcaemia, renal failure, anaemia, and bone lesions). These changes are based on the identifi cation of biomarkers associated with near inevitable development of CRAB features in patients who would otherwise be regarded as having smouldering multiple myeloma. A delay in application of the label of multiple myeloma and postponement of therapy could be detrimental to these patients. In addition to this change, we clarify and update the underlying laboratory and radiographic variables that fulfi l the criteria for the presence of myeloma-defi ning CRAB features, and the histological and monoclonal protein requirements for the disease diagnosis. Finally, we provide specifi c metrics that new biomarkers should meet for inclusion in the disease defi nition. The International Myeloma Working Group recommends the implementation of these criteria in routine practice and in future clinical trials, and recommends that future studies analyse any diff erences in outcome that might occur as a result of the new disease defi nition.

show abstract

“…In the second study of 663 consecutive patients who underwent stem cell transplantation for PCM, 55 (8Á3%) cases had EMD, comprising 8 (14Á5%) for whom EMD was present at diagnosis and 42 (76%) patients who developed EMD at the time of relapse (Weinstock et al, 2015). The inherent fallibility of BM-based MRD assessment of PCM in the setting of patchy disease was exemplified by two separate groups, expert in FC, who demonstrated occult marrow disease by FC in 49% and 68% of patients with solitary plasmacytoma of bone respectively (Hill et al, 2014;Paiva et al, 2014), and 38% of patients with EMD , thus confirming the absence of detectable BM disease in the substantial remainder.…”

Section: á3-8á0 (Median 0á9) Disease Duration (Years) 1á2-7á1 (Mediamentioning

confidence: 99%

Aggressive and extramedullary plasma cell myeloma evade bone marrow flow cytometric minimal residual disease detection

et al. 2015

View full text Add to dashboard Cite

We were interested to read the recent publication by Weinstock and colleagues (Weinstock et al, 2015), which described the incidence and clinical features of 55 cases of biopsy-proven extramedullary multiple myeloma, derived from a large cohort of consecutive patients who underwent stem cell transplantation, noting that the majority of this uncommon manifestation occurred at relapse. These findings were of particular interest to us as we recently collected data from patients undergoing minimal residual disease (MRD) assessment for plasma cell myeloma (PCM) by flow cytometry (FC), and focused our attention on those for whom disease was undetectable in the bone marrow (BM) but present elsewhere, and also found, with smaller numbers, that extramedullary disease (EMD) was more often the reason for a 'false 20* S, HDT, I (patient 6) 3 I, P, HDT (patient 4) 3 S, I, HDAC (patient 5) 1 P 1 S, HDT x 2, I 2 S, HDT 2 S, HDT, P 1 S, HDT, I, P (patient 8) 1 S, HDT x 2, I, P (patient 7) 3 S, HDT, I, P, HDAC 3 S, HDT x 2, I, P, HDAC 1 S, HDT, I, P, Ex, Ex 1 *Uniformly treated (N = 16); ISS, International Staging System; S, standard therapy (corticosteroid and conventional cytotoxic chemotherapy); I, immunomodulatory (thalidomide or lenalidomide); HDT, high dose therapy (melphalan/autologous stem cell transplant with cyclophosphamide stem cell mobilization); HDAC, histone deacetylase inhibitor; P, proteasome inhibitor; Ex, experimental agent.

show abstract

Multiparameter flow cytometry for staging of solitary bone plasmacytoma: new criteria for risk of progression to myeloma

Abstract: Key Points MFC is a valuable biomarker to discriminate “true” SBP patients from those with “occult” BM clonal PCs and high-risk of progression to MM.

Cited by 66 publications

References 14 publications

Radiotherapy Alone is Associated with Improved Outcomes Over Surgery in the Management of Solitary Plasmacytoma

Radiotherapy Alone is Associated with Improved Outcomes Over Surgery in the Management of Solitary Plasmacytoma

International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma

Aggressive and extramedullary plasma cell myeloma evade bone marrow flow cytometric minimal residual disease detection

Contact Info

Product

Resources

About