Solitary plasmacytoma of bone and extramedullary plasmacytoma: Two different entities?

Galieni, Piero; Cavo, Michèle; Avvisati, Giuseppe; Pulsoni, Alessandro; Falbo, Rosanna; Bonelli, M. A.; Russo, Domenico; Petrucci, Maria Teresa; Bucalossi, Alessandro; Tura, S

doi:10.1093/oxfordjournals.annonc.a059285

Cited by 99 publications

(77 citation statements)

References 15 publications

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“…A bony presentation was consistently demonstrated to have a higher risk of MM progression with a 10-year rate of 76%, compared with an extramedullary presentation, in which the 10-year MM rate was 36% [2]. Subclinical osteopenia [33] or abnormal MRI scan of the spine [10,34,35] reflects presence of occult disease, and predicts rapid progression to systemic myeloma. A suppression of the normal immunoglobulin classes, also known as immunoparesis, correlates with a higher risk of progressing to MM [33,36].…”

Section: Prognostic Factors Affecting the Outcomementioning

confidence: 98%

“…Subclinical osteopenia [33] or abnormal MRI scan of the spine [10,34,35] reflects presence of occult disease, and predicts rapid progression to systemic myeloma. A suppression of the normal immunoglobulin classes, also known as immunoparesis, correlates with a higher risk of progressing to MM [33,36]. M-protein levels are reported to be a predictive factor of occult disseminated disease, and patients showing persistent M-protein levels for more than one year after RT are prone to progress to MM [8,16,37].…”

Section: Prognostic Factors Affecting the Outcomementioning

confidence: 99%

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Radiation therapy for the solitary plasmacytoma

Kocak

Ballerini²,

Zouhair³

et al. 2010

Turk J Hematol

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Plasma-cell neoplasms are classically categorized into four groups as: multiple myeloma (MM), plasma-cell leukemias, solitary plasmacytomas (SP) of the bone (SPB), and extramedullary plasmacytomas (EMP). These tumors may be described as localized or diffuse in presentation. Localized plasma-cell neoplasms are rare, and include SP of the skeletal system, accounting for 2-5% of all plasma-cell neoplasms, and EMP of soft tissue, accounting for approximately 3% of all such neoplasms. SP is defined as a solitary mass of neoplastic plasma cells either in the bone marrow or in various soft tissue sites. There appears to be a continuum in which SP often progresses to MM. The main treatment modality for SP is radiation therapy (RT). However, there are no conclusive data in the literature on the optimal RT dose for SP. This review describes the interrelationship of plasma-cell neoplasms, and attempts to determine the minimal RT dose required to obtain local control. (Turk J Hematol 2010; 27: 57-61) Key words: Solitary plasmacytoma, radiotherapy, multiple myeloma, management Received: September 17, 2009 Accepted: March 3, 2010 ÖzetPlazma hücre malignitesi klasik olarak dört gruptur: multiple myelom (MM), plazma hücre lösemisi, kemik yerleşimli soliter plazmasitom (SPB) ve ekstrameduller yerleşimli plazmasitom (EMP). Lokalize plazma hücre malignitesini iskelet sistemi yerleşimli SP ve EMP oluşturur. Plazmasitoma birçok farklı şekilde tanımlanabilir. Çoğunlukla kemik iliğinde veya yumuşak dokuda plazma hücrelerinden oluşan bir kitle şeklinde görülür. Henüz, soliter plazmositomların MM'a dönüşümü arasindaki ilişki tam olarak tanımlanmamıştır. Soliter plazmositomlar, hem SPB hem de EMP için ana tedavi radyoterapidir. Ancak, SP için uygun tedavi dozu için ortak bir data yoktur. Lokal kontrol için optimal doz hastalığın yerine ve boyutuna bağlı olarak 30 ve 50 Gy arasında değişmektedir. Bu derlemede lokal kontrol için minimal RT dozu tanımlanmaya çalışılmıştır.(Turk J Hematol 2010; 27: 57-61) Anahtar kelimeler: Soliter plazmasitom, radyoterapi, multipl miyelom, tedavi yaklaşımı

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Section: Prognostic Factors Affecting the Outcomementioning

confidence: 98%

Section: Prognostic Factors Affecting the Outcomementioning

confidence: 99%

Radiation therapy for the solitary plasmacytoma

Kocak

Ballerini²,

Zouhair³

et al. 2010

Turk J Hematol

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“…Although both neoplasms originate from the same cell type, distinct features concerning progression to multiple myeloma suggest two different pathologic entities [3] Patients typically present with symptoms caused by local tumor mass: pain and neurological deficits in the case of SBP, dysphagia, breathing problems and epistaxis in the case of EP of the head-and-neck region.…”

mentioning

confidence: 99%

Radiotherapy of solitary plasmacytoma

et al. 2011

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International audienceSolitary plasmacytoma of the bone (SBP) or extramedullary plasmacytoma (EP) are rare neoplasms amenable to local radiotherapy. In this retrospective analysis, we report the University Heidelberg experience in the treatment of solitary plasmacytoma. From 1995 to 2008, 18 patients were treated with local radiotherapy. Ten patients suffered from SBP, eight patients showed a single extramedullary lesion. Local radiotherapy with a median dose of 45 Gy yielded excellent local control with only one patient suffering from local relapse. SBP and EP had significantly different 5-year multiple myeloma-free survival rates of 36.8% and 86.7%, respectively. However, no significant difference in overall survival could be detected. Radiotherapy can achieve excellent local control of solitary plasmacytoma. Progression to multiple myeloma, especially in the case of SBP, remains to be addressed by further studies

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“…We had one case (14.3 %) that developed MM after 20 months of follow-up. Although the risk of development into MM is increased within 2 years following diagnosis, it has been demonstrated to occur even after 15 years of disease free period [1,3,22], suggesting the need for a long-term follow-up. Although some authors consider that plasmacytoma converted into MM has better prognosis than classic MM [23] our patient died from the disease after 4 months despite intensive treatment.…”

Section: Discussionmentioning

confidence: 99%

Extramedullary Plasmacytoma of the Paranasal Sinuses: Combining Surgery with External Radiotherapy

Vlad

Trombitaș

Albu

2015

Indian J Otolaryngol Head Neck Surg

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Extramedullary plasmacytomas (EMP) are rare neoplasms characterized by the proliferation of a single B-lymphoid cell clone, arising primarily in the head and neck region. The purpose of this study is to report our experience in the management of EMPs arising in the paranasal sinuses. We retrospectively reviewed clinical records of 7 patients (4 men and 3 women), admitted between 1995 and 2010 for EMPs of the paranasal sinuses-5 within the ethmoid and 2 in the maxillary sinus. Treatment consisted in endoscopic resection followed by external RT. The mean follow-up period is 50 months (range 9-67 months). Local recurrences developed in 2 out of 7 cases. Both recurrences occurred in maxillary EMPs and they underwent salvage treatment-combination of RT and surgery. At the time of analyzing these data 5 patients (70 %) were alive and two (30 %) have died of their disease. A single patient, presenting local relapse at 6 months, died due to the disease at 9 months. One patient progressed to multiple myeloma. Larger controlled clinical trials are necessary to establish an optimal treatment of choice that implies an individualized management of these patients.

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Solitary plasmacytoma of bone and extramedullary plasmacytoma: Two different entities?

Abstract: Although EP and SPB are both localized forms of plasma cell dyscrasias, SPB seems to have a greater tendency to progression MM. It appears, however, that the apparent stronger propensity of SPB to progress is actually due to the great number of cases that at diagnosis conceal an occult MM.

Cited by 99 publications

References 15 publications

Radiation therapy for the solitary plasmacytoma

Radiation therapy for the solitary plasmacytoma

Radiotherapy of solitary plasmacytoma

Extramedullary Plasmacytoma of the Paranasal Sinuses: Combining Surgery with External Radiotherapy

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