Clinical features, outcome, and prognostic factors for survival and evolution to multiple myeloma of solitary plasmacytomas: A report of the Greek myeloma study group in 97 patients
Clinical features, outcome, and prognostic factors for survival and evolution to multiple myeloma of solitary plasmacytomas: A report of the Greek myeloma study group in 97 patients
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DOI：
10.1002/ajh.23745
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发表时间：
2014-08-01
影响因子：
12.8
通讯作者：
Dimopoulos, Meletios A.
中科院分区：
文献类型：
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作者：
Katodritou, Eirini;Terpos, Evangelos;Dimopoulos, Meletios A.
孤立性浆细胞瘤（SP）是一种罕见的浆细胞恶液质，其特征是存在骨或髓外浆细胞肿瘤。选择的治疗方法是局部放射治疗 (R/T) +/- 手术切除。辅助化疗 (C/T) 或新型药物 (NA) 的作用尚不确定。与预后因素相关的数据尚无定论。在此，我们描述了在 12 个希腊骨髓瘤中心诊断和治疗的 97 名连续患者的临床特征、生存率和预后，其中 65 名患有骨 SP (SBP)，32 名患有髓外 SP (SEP)。客观缓解率（≥ PR）和完全缓解（CR）分别为 91.8% 和 61.9%，两组之间没有差异。总体而言，38 名患者复发或进展为多发性骨髓瘤 (MM)。中位随访 60 个月后，SEP 的 5 年和 10 年总生存 (OS) 概率分别为 92% 和 89%，SBP 的 5 年和 10 年总生存 (OS) 概率分别为 86% 和 69%（P = 0.2）。 SEP 患者的 5 年和 10 年无 MM 生存 (MMFS) 概率分别为 90% 和 70%，而 SBP 患者的 59% 和 50%（P = 0.054）。总体而言，5 年和 10 年 OS 概率、浆细胞瘤无复发生存率 (PRFS)、无进展生存率和 MMFS 分别为 84% 和 78%、72% 和 58%、58% 和 43%、70% 和 59%。在多变量分析中，延长的 PRFS 和年轻的年龄是 OS 的积极预测因子。 CR 的实现是 PRFS 的唯一积极预测指标。免疫轻瘫是进展为 MM 的唯一负面预测因子。添加 C/T 或基于 NA 的治疗增加了毒性，但与 R/T 相比没有任何生存优势。 (C) 2014 年 Wiley 期刊公司。
Solitary plasmacytoma (SP) is a rare plasma cell dyscrasia characterized by the presence of bone or extramedullary plasma cell tumors. The treatment of choice is local radiotherapy (R/T) +/- surgical excision. The role of adjuvant chemotherapy (C/T) or novel agents (NA) is uncertain. Data related to prognostic factors are inconclusive. Herein, we describe the clinical features, survival and prognosis of 97 consecutive patients, 65 with bone SP (SBP), and 32 with extramedullary SP (SEP), diagnosed and treated in 12 Greek Myeloma Centers. Objective response rate (>= PR) and complete response (CR) was 91.8% and 61.9%, respectively, and did not differ between the 2 groups. Overall, 38 patients relapsed or progressed to multiple myeloma (MM). After a median follow-up of 60 months, 5 and 10-year overall survival (OS) probability was 92% and 89% in SEP and 86% and 69% in SBP, respectively (P = 0.2). The 5- and 10-year MM-free survival (MMFS) probability was 90% and 70% for patients with SEP vs. 59% and 50% for patients with SBP, respectively (P = 0.054). Overall, the 5- and 10-year OS probability, plasmacytoma relapse-free survival (PRFS), progression-free survival and MMFS was 84% and 78%, 72% and 58%, 58% and 43%, and 70% and 59%, respectively. In the multivariate analysis, prolonged PRFS and young age were positive predictors of OS. Achievement of CR was the only positive predictor of PRFS. Immunoparesis was the only negative predictor of progression to MM. The addition of C/T or NA-based treatment increased toxicity without offering any survival advantage over R/T. (C) 2014 Wiley Periodicals, Inc.