Despina Fotiou1, Meletios A Dimopoulos1, Efstathios Kastritis2. 1. Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. 2. Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. ekastritis@gmail.com.
Abstract
PURPOSE OF REVIEW: To discuss the diagnostic approach, treatment options, and future considerations in the management of plasmacytomas, either solitary or in the context of overt multiple myeloma (MM). RECENT FINDINGS: Advanced imaging techniques such as whole-body magnetic resonance imaging and positron emission tomography/computerized tomography are essential for the diagnostic workup of solitary plasmacytomas (SP) to rule out the presence of other disease foci. The role of flow cytometry and clonal plasma cell detection is currently under study together with other prognostic factors for the identification of patients with SP at high risk of progression to overt MM. Solitary plasmacytomas are treated effectively with local radiotherapy whereas systemic therapy is required at relapse. Clonal plasma cells that accumulate at extramedullary sites have distinct biological characteristics. Patients with MM and soft tissue involvement have poor outcomes and should be treated as ultra-high risk. A revised definition of SP that distinguishes between true solitary clonal PC accumulations and SP with minimal bone marrow involvement should be considered to guide an appropriate therapeutic and follow-up approach. Future studies should be conducted to determine optimum treatment approaches for patients with MM and paraskeletal or extramedullary disease.
PURPOSE OF REVIEW: To discuss the diagnostic approach, treatment options, and future considerations in the management of plasmacytomas, either solitary or in the context of overt multiple myeloma (MM). RECENT FINDINGS: Advanced imaging techniques such as whole-body magnetic resonance imaging and positron emission tomography/computerized tomography are essential for the diagnostic workup of solitary plasmacytomas (SP) to rule out the presence of other disease foci. The role of flow cytometry and clonal plasma cell detection is currently under study together with other prognostic factors for the identification of patients with SP at high risk of progression to overt MM. Solitary plasmacytomas are treated effectively with local radiotherapy whereas systemic therapy is required at relapse. Clonal plasma cells that accumulate at extramedullary sites have distinct biological characteristics. Patients with MM and soft tissue involvement have poor outcomes and should be treated as ultra-high risk. A revised definition of SP that distinguishes between true solitary clonal PC accumulations and SP with minimal bone marrow involvement should be considered to guide an appropriate therapeutic and follow-up approach. Future studies should be conducted to determine optimum treatment approaches for patients with MM and paraskeletal or extramedullary disease.
Entities:
Keywords:
Bone disease; Extramedullary; Plasma cells; Solitary lesion; Tumor
Authors: David Dingli; Robert A Kyle; S Vincent Rajkumar; Grzegorz S Nowakowski; Dirk R Larson; John P Bida; Morie A Gertz; Terry M Therneau; L Joseph Melton; Angela Dispenzieri; Jerry A Katzmann Journal: Blood Date: 2006-06-01 Impact factor: 22.113
Authors: Mahmut Ozsahin; Richard W Tsang; Philip Poortmans; Yazid Belkacémi; Michel Bolla; Fazilet Oner Dinçbas; Christine Landmann; Bernard Castelain; Jeroen Buijsen; Jürgen Curschmann; Sidney P Kadish; Anna Kowalczyk; Yavuz Anacak; Josef Hammer; Tan D Nguyen; Gabriela Studer; Rachel Cooper; Meriç Sengöz; Luciano Scandolaro; Abderrahim Zouhair Journal: Int J Radiat Oncol Biol Phys Date: 2005-10-17 Impact factor: 7.038
Authors: P Galieni; M Cavo; G Avvisati; A Pulsoni; R Falbo; M A Bonelli; D Russo; M T Petrucci; A Bucalossi; S Tura Journal: Ann Oncol Date: 1995-09 Impact factor: 32.976
Authors: Jo Caers; Marie-Christiane Vekemans; Greet Bries; Karolien Beel; Vanessa Delrieu; Anne Deweweire; Hilde Demuynck; Bernard De Prijck; Hadewijch De Samblanx; Alain Kentos; Nathalie Meuleman; Philippe Mineur; Fritz Offner; Isabelle Vande Broek; Jan Van Droogenbroeck; Ann Vande Velde; Ka Lung Wu; Michel Delforge; Rik Schots; Chantal Doyen Journal: Ann Med Date: 2013-06-14 Impact factor: 4.709
Authors: A Dispenzieri; R Kyle; G Merlini; J S Miguel; H Ludwig; R Hajek; A Palumbo; S Jagannath; J Blade; S Lonial; M Dimopoulos; R Comenzo; H Einsele; B Barlogie; K Anderson; M Gertz; J L Harousseau; M Attal; P Tosi; P Sonneveld; M Boccadoro; G Morgan; P Richardson; O Sezer; M V Mateos; M Cavo; D Joshua; I Turesson; W Chen; K Shimizu; R Powles; S V Rajkumar; B G M Durie Journal: Leukemia Date: 2008-11-20 Impact factor: 11.528
Authors: Justin Komisarof; Jodi Lipof; Joseph DiTursi; Amit Chowdhry; Hae Yoon Grace Choung; W Richard Burack; Louis Constine; Frank Passero Journal: Case Rep Hematol Date: 2022-02-21
Authors: Khaled Elsayad; Michael Oertel; Laila König; Sebastian Hüske; Emmanuelle Le Ray; Mohamed A M Meheissen; Amr Abdelaziz Elsaid; Essam Elfaham; Jürgen Debus; Youlia Kirova; Klaus Herfarth; Hans Theodor Eich Journal: Cancers (Basel) Date: 2020-03-13 Impact factor: 6.639