Prognostic factors in solitary plasmacytoma of the bone: a multicenter Rare Cancer Network study

Knobel, David; Zouhair, Abderrahim; Tsang, Richard W.; Poortmans, Philip; Belkacémi, Yazid; Bolla, M.; Oner, F; Landmann, Christine; Castelain, B.; Ozşahin, Mahmut

doi:10.1186/1471-2407-6-118

Cited by 170 publications

(160 citation statements)

References 37 publications

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“…on May 12, 2018. by guest www.bloodjournal.org From Figure 1B). In contrast to previous studies, [3][4][5][6][7][8][9][10]15 age, sex, vertebral location, or the presence of an M protein at diagnosis or its persistence at 1 year post-irradiation did not predict progression. The value of OMD and ULC were retained in multivariate analysis (P 5 .041 and .009, respectively; Table 1).…”

Section: ) (B)contrasting

confidence: 95%

“…The median TTP in this cohort was 49 months (18 months in those who progressed), and this along with the overall proportion of patients progressing is broadly comparable with previous series. [3][4][5][6][7][8][9][10] Progression was documented in 72% (26/34) of patients with OMD compared with 12.5% (2/16) without, and the median TTP was 26 months vs not reached (NR) (P 5 .003; Figure 1A). In a similar analysis, Warsame et al have demonstrated that the presence of clonal plasma cells (as determined by trephine biopsy immunohistochemistry), but below the 10% threshold for the diagnosis of myeloma, was associated with progression.…”

Section: Resultsmentioning

confidence: 99%

“…The overall incidence of progression is 37% to 72%, with median reported times to progression (TTP) of 2 years or less. [3][4][5][6][7][8][9][10] We hypothesized that progression in SPB might occur as a result of occult disease outside of the irradiation field. To further evaluate this, we used multiparameter flow cytometry (MFC) to assess staging bone marrow (BM) samples for the presence of occult disease and determine its impact on outcome.…”

Section: Introductionmentioning

confidence: 99%

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Outcome prediction in plasmacytoma of bone: a risk model utilizing bone marrow flow cytometry and light-chain analysis

Hill

Rawstron

Tute

et al. 2014

Blood

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Key Points• Occult marrow disease is demonstrable in 68% of patients with solitary plasmacytoma of bone and is predictive of progression.• Trials of adjuvant systemic therapy are warranted in high-risk patients.The purpose of this study was to use multiparameter flow cytometry to detect occult marrow disease (OMD) in patients with solitary plasmacytoma of bone and assess its value in predicting outcome. Aberrant phenotype plasma cells were demonstrable in 34 of 50 (68%) patients and comprised a median of 0.52% of bone marrow leukocytes. With a median follow-up of 3.7 years, 28 of 50 patients have progressed with a median time to progression (TTP) of 18 months. Progression was documented in 72% of patients with OMD vs 12.5% without (median TTP, 26 months vs not reached; P 5 .003). Monoclonal urinary light chains (ULC) were similarly predictive of outcome because progression was documented in 91% vs 44% without (median TTP, 16 vs 82 months; P < .001). By using both parameters, it was possible to define patients with an excellent outcome (lacking both OMD and ULC, 7.7% progression) and high-risk patients (OMD and/or ULC, 75% progression; P 5 .001). Trials of systemic therapy are warranted in high-risk patients. (Blood. 2014;124(8):1296-1299 IntroductionSolitary plasmacytoma of bone (SPB) is characterized by localized areas of bone destruction by monoclonal plasma cells in the absence of clinical, laboratory, and radiologic features of multiple myeloma (MM). 1 Local irradiation remains the treatment of choice. United Kingdom national guidelines recommend doses of 40 to 50 Gy depending on tumor size, with a 2-cm margin, because this provides excellent local control.2 A significant proportion of patients will however progress with new lesions outside the irradiation field or, more typically, with generalized myeloma. The overall incidence of progression is 37% to 72%, with median reported times to progression (TTP) of 2 years or less. [3][4][5][6][7][8][9][10] We hypothesized that progression in SPB might occur as a result of occult disease outside of the irradiation field. To further evaluate this, we used multiparameter flow cytometry (MFC) to assess staging bone marrow (BM) samples for the presence of occult disease and determine its impact on outcome. Patients and methodsFifty patients (median age, 65years) with a histologically confirmed diagnosis of SPB according to International Myeloma Working Group (IMWG) criteria 1 were evaluated between 1998 and 2008. The solitary nature of the presenting lesion was confirmed by plain radiography in all patients, and 35 also had negative spinal magnetic resonance imaging results. Positron emission tomography (PET) scanning was not routinely performed. Thirty-five of 50 patients had a monoclonal protein (27 IgG, 7 IgA, and 1 light-chain only) with a median concentration of 7 g/L. Urine immunofixation demonstrated monoclonal urinary light chains (ULC) in 11 of 45 patients, but the serum-free light-chain (SFLC) assay was not routinely available. Patients were treated in two r...

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Section: ) (B)contrasting

confidence: 95%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Outcome prediction in plasmacytoma of bone: a risk model utilizing bone marrow flow cytometry and light-chain analysis

Hill

Rawstron

Tute

et al. 2014

Blood

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“…The dose is usually in the order of 40-50 Gy given in 20-25 fractions over a four-week period, depending on tumour size [6]. Response rates to radiotherapy are typically in excess of 80% [7][8][9].…”

Section: Discussionmentioning

confidence: 99%

“…Although initial local responses are excellent, the majority of patients will develop multiple myeloma [9,11]. For this reason, regular follow-up of all patients treated for SPB needs to be emphasised.…”

Section: Discussionmentioning

confidence: 99%

Cranial Plasmacytoma: A Case Series and Review of the Literature

Webb

Barrett

et al. 2011

Indian J Hematol Blood Transfus

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Plasmacytomas are malignant proliferations of plasma cells which can occur with different plasma cell dyscrasias. Solitary plasmacytomas of bone or extraosseous plasmacytomas, depending on the tissue of origin, develop in isolation without systemic manifestations of multiple myeloma. Three cases of cranial plasmacytomas are described, two in patients with multiple myeloma and one extraosseous plasmacytoma. Management options are discussed.

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Multiple Myeloma

Bianchi

Anderson

2018

The American Cancer Society's Oncology in Practice

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Prognostic factors in solitary plasmacytoma of the bone: a multicenter Rare Cancer Network study

Cited by 170 publications

References 37 publications

Outcome prediction in plasmacytoma of bone: a risk model utilizing bone marrow flow cytometry and light-chain analysis

Outcome prediction in plasmacytoma of bone: a risk model utilizing bone marrow flow cytometry and light-chain analysis

Cranial Plasmacytoma: A Case Series and Review of the Literature

Multiple Myeloma

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