Solitary Plasmacytoma Treated by Lenalidomide-Dexamethasone in Combination with Radiation Therapy: Clinical Outcomes

Mignot, Fabien; Schernberg, Antoine; Arsène-Henry, A.; Vignon, Marguerite; Bouscary, Didier; Kirova, Youlia

doi:10.1016/j.ijrobp.2019.10.043

Cited by 22 publications

(17 citation statements)

References 24 publications

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“…The use of bortezomib in treating solitary plasmacytoma has been reported in several case reports, which suggested the possible efficacy of bortezomib in treating solitary plasmacytoma. Additionally, in a single‐center retrospective study by Mignot et al, patients with solitary plasmacytoma treated with lenalidomide‐dexamethasone with intensity‐modulated radiation therapy (IMRT) had longer multiple myeloma‐free survival and progression‐free survival than treated IMRT alone 14 . In this study, the majority of patients had SPB (87%), suggesting the addition of lenalidomide to radiotherapy could improve the outcomes of patients with SPB.…”

Section: Discussionmentioning

confidence: 59%

Survival trends and prognostic factors in patients with solitary plasmacytoma of bone: A population‐based study

Shen

Liu

et al. 2020

Cancer Medicine

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Solitary plasmacytoma of bone (SPB) is a single, isolated plasmacytoma originated from the bone. The survival trends of patients with SPB in recent years remain unknown. And the prognostic system of SPB may also need to be refined. The 18 Surveillance, Epidemiology, and End Results (SEER) databases of the National Cancer Institute in the United States were used to extract data for this study. The third edition of the International Classification of Disease for Oncology (ICD‐O‐3) code 9731 was used to identify cases of SPB. For each case, factors including age at the time of diagnosis, sex, race, marital status, insurance status, primary sites of tumors, and the use of surgery were collected. The outcomes of patients with SPB were compared between two groups. And the prognostic impacts of baseline characteristics and use of surgery was studied. A total of 4103 (from 1976 to 2016) cases of SPB were identified. The median age was 65 years old. Patients in time period‐2 (2008–2016) show better survival as compared to those in time period‐1(1976–2007) (median overall survival: 88 months vs . 73 months, p = 0.0332). Age ≤ 65 years and being male were associated with better outcomes. The widowed individuals had significantly inferior survival and myeloma‐specific survival than the single, married, or divorced individuals ( p values all <0.0001). Patients with lesions in bones of skull and face and associated joints had longer survival as compared with those with bone lesions in other sites (median overall survival: 107 months vs . 79 months, p = 0.0694). The use of surgery was significantly associated with improved survival (median survival: surgery performed 98 months vs . not performed 73 months, hazards ratio [HR]: 0.7623, 95% CI: 0.7009–0.8472; p < 0.0001) and myeloma‐specific survival (median myeloma‐specific survival: surgery 160.0 months vs . no surgery 143.0 months, HR: 0.8469, 95% CI: 0.7493–0.9572; p = 0.0078). Multivariable analysis revealed that surgery, marital status, and age were independent prognostic factors for overall survival in patients with SPB. The improvement in the survival of patients with SPB has been observed in recent years. And several potential prognostic factors were identified. Future prospective studies are warranted to explore the roles of novel agents, surgery, and systemic chemotherapy in the treatment of SPB.

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Section: Discussionmentioning

confidence: 59%

Survival trends and prognostic factors in patients with solitary plasmacytoma of bone: A population‐based study

Shen

Liu

et al. 2020

Cancer Medicine

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“…The use of prophylactic chemotherapy is controversial in solitary plasmacytoma. Apart from a few small studies, most of the existing literature does not support the use of chemotherapy in solitary plasmacytoma [10].…”

Section: Resultsmentioning

confidence: 99%

Inion Bony Solitary Plasmocytoma: A Case Report

Agrawal

Dholakia

2020

Iran J Neurosurg

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ackground and Importance: Plasma Cell Dyscrasias (PCD) are a heterogeneous group of diseases having a spectrum from multiple myeloma to solitary plasmacytoma, a rare subtype, which constitutes 2 to 5% of all PCD. It typically involves axial bones but the involvement of skull bone is very rare. Case Presentation: We are reporting a case of inion bony lesion with venous sinus infiltration in a 55-year-old male patient, presented with pain, imbalance in walking, and swelling in the occipital region. Brain MRI suggested an extra-axial lesion with skull involvement and venous sinus infiltration. The tumor was infiltrating into the sinus with patent torcular venous confluence. Tumor decompression followed by radiosurgery of residual lesion was considered in pre-operative surgical planning. It was diagnosed as a case of myeloma cell disease on histopathology. Postoperative myeloma work-up confirmed the absence of any systemic involvement. The patient was given a course of radiotherapy. Conclusion: One-year follow-up with repeated MRI and myeloma investigations in the 3rd month, 6th months, and 1 year did not show any finding suggestive of progression to multiple myeloma. The follow-up of brain MRI showed a complete resolution of the residual tumor.

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“…It is possible that the patient's disease could have been controlled with radiotherapy alone. However, recent studies have found a significant benefit to systemic therapy for solitary plasmacytoma, with significantly lower rates of progression to multiple myeloma [ 26 , 27 ]. Furthermore, in this case, due to the extreme size of the mass, initiating treatment with systemic therapy resulted in the shrinking of the tumor and thus reduction in the area requiring radiation.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Case of Multiple Myeloma with Light-Chain Cast Nephropathy Secondary to a Very Large Plasmacytoma without Bone Marrow Involvement

Komisarof

Lipof²,

DiTursi

et al. 2022

Case Reports in Hematology

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Here, we report a case of a patient who presented to Strong Memorial Hospital with new-onset renal failure and anemia and was found to have multiple myeloma with lambda light-chain cast nephropathy secondary to a very large (14 cm × 14 cm × 12 cm) plasmacytoma without bone marrow involvement. This case is notable as solitary plasmacytomas are almost never seen with concomitant myeloma-defining CRAB criteria or significantly elevated serum free light-chain ratios. Although solitary plasmacytomas are typically definitively treated with radiation, this case highlights that systemic treatment may be helpful in certain clinical scenarios.

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Solitary Plasmacytoma Treated by Lenalidomide-Dexamethasone in Combination with Radiation Therapy: Clinical Outcomes

Cited by 22 publications

References 24 publications

Survival trends and prognostic factors in patients with solitary plasmacytoma of bone: A population‐based study

Survival trends and prognostic factors in patients with solitary plasmacytoma of bone: A population‐based study

Inion Bony Solitary Plasmocytoma: A Case Report

An Unusual Case of Multiple Myeloma with Light-Chain Cast Nephropathy Secondary to a Very Large Plasmacytoma without Bone Marrow Involvement

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