Localised plasmacytomas in Taiwan : comparison between extrameduliary plasmacytoma and solitary plasmacytoma of bone
Localised plasmacytomas in Taiwan : comparison between extrameduliary plasmacytoma and solitary plasmacytoma of bone
复制标题
台湾局限性浆细胞瘤：髓外浆细胞瘤与骨孤立性浆细胞瘤的比较
DOI：
--
复制
发表时间：
2007
期刊：
影响因子：
--
通讯作者：
P. N. Wang
中科院分区：
文献类型：
--
作者：
L. Shih;P. Dunn;W. Leung;W. Chen;P. N. Wang
并将髓外浆细胞瘤（EMP）与骨孤立性浆细胞瘤（SPB）作了比较。22例患者患有SPB，10例患有EMP，占我们所有浆细胞肿瘤的9%。两组均以男性为主，SPB的中位年龄为54岁，EMP为63岁。SPB的常见部位为椎体（15例）和颅骨（4例）。大多数EMP发生在口鼻咽部（6例）和鼻窦（2例）。在8例SPB患者和6例EMP患者中检测到M蛋白。17例SPB和7例EMP患者接受了放射治疗，均获得了初步的局部控制。22例SPB患者的失败模式表现为2例局部复发，2例多发性骨转移但无骨髓浆细胞增多，2例多发性EMP进展，1例发展为多发性骨髓瘤（MM）。EMP组中有2例局部复发，1例进一步孤立骨受累和1例MM转化。局部复发或播散与两组中M蛋白的出现或M蛋白水平的升高相关。两组间M蛋白状态或失败发生率和模式无显著差异。EMP患者的总生存率高于SPB患者（P = 0.03）。EMP组5年无瘤生存率为79%，SPB组为58%（P = 0.53）。年龄小于60岁的患者在SPB组有更好的总生存率，但肿瘤的位置，M蛋白的存在，放射剂量和化疗并不影响两组的预后。我们的研究结果表明，适当的局部治疗可以使局部浆细胞瘤患者长期生存，MM进展的频率较低，EMP和SPB在失败的频率和模式方面似乎相似。
are presented, and a companson between extramedullary plasmacytoma (EMP) and solitary plasmacytoma of bone (SPB) is made. Twenty-two patients had SPB and ten had EMP, accounting for 9% of all of our plasma cell neoplasms. Both groups had a male predominance with a median age of 54 years for SPB and 63 years for EMP. The common sites of SPB included vertebral bodies (15) and the skull (4). Most EMPs occurred in the oronasopharynx (6) and paranasal sinuses (2). An M-protein was detected in eight patients with SPB and in six with EMP. Seventeen patients with SPB and seven with EMP received radiation therapy, and all achieved initial local control. The pattern of failure in 22 patients with SPB manifested as local recurrence in two, multiple bone metastases without bone marrow plasmacytosis in two, multiple EMP progression in two, and development of multiple myeloma (MM) in one. There were two local recurrences, one further solitary bone involvement and one MM conversion in the EMP group. Local recurrence or dissemination was associated with the appearance of M-protein or an increase in the M-protein level in both groups. There was no significant difference in M-protein status or incidence and patterns of failure between the two groups. Patients with EMP had a more favourable overall survival than those with SPB (P = 0.03). The 5 year disease-free survival rate was 79% for EMP and 58% for SPB (P = 0.53). Patients aged less than 60 years had a better overall survival in the SPB group, but location of tumour, presence of M-protein, radiation dose and chemotherapy did not influence prognosis in either group. Our results indicate that adequate local therapy can result in long-term survival with a low frequency of MM progression for patients with localised plasmacytomas, and both EMP and SPB appear to be similar in terms of frequency and patterns of failure.