International Myeloma Working Group Recommendations for the Diagnosis and Management of Solitary Plasmacytomas
Abstract
Solitary plasmacytomas (SPs) are rare localized tumors of clonal plasma cells, either in the bone (solitary bone plasmacytoma) or in soft tissue/extraosseous (extramedullary) with either no or with minimal bone marrow (BM) infiltration (<10% clonal plasma cells by immunohistochemistry) and no evidence of systemic involvement or myeloma defining events. Approximately 50% of SPs will progress to symptomatic myeloma within 5 years after initial definitive local radiotherapy. Increased availability of improved diagnostic and monitoring tools has increased the sensitivity of detection of additional lesions and marrow involvement and has implications for the follow-up strategy after treatment. Thus, the definitions and requirements for the diagnosis and follow-up of SPs are evolving. The diagnosis of SP requires the careful exclusion of multiple myeloma (MM) that would require systemic therapy, by using all the available methods to detect systemic disease (advanced imaging, sensitive BM assessment methods, blood and urine tests). Local radiotherapy remains the mainstay of therapy, and despite the availability of innovative drugs for MM, the clinical benefit of systemic therapy currently remains poorly defined. The International Myeloma Working Group provides here updated recommendations for the diagnosis, evaluation, treatment, and response assessment of patients with SPs, incorporating recent data and advances in diagnostic tools.
Article Details
Journal Info
Journal of Clinical Oncology
Lippincott Williams & Wilkins
Authors (32)
Efstathios Kastritis
Shaji K. Kumar
Division of Hematology, Mayo Clinic, Rochester, MN
Vincent S. Rajkumar
Division of Hematology, Mayo Clinic, Rochester, MN
Wee Joo Chng
Luciano Costa
42Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, United States
Monika Engelhardt
Wilson Gonsalves
1Mayo Clinic, Rochester, United States
Vania Hungria
Clinica São Germano, São Paulo
Jens Hillengass
Roswell Park Comprehensive Cancer Center
Dragan Jevremovic
1Mayo Clinic, Rochester, United States
Eirini Katodritou
Theagenio Cancer Hospital, Thessaloniki, Greece
Sigurður Yngvi Kristinsson
Sagar Lonial
Emory University, Atlanta
Heinz Ludwig
Philip McCarthy
8Roswell Park Comprehensive Cancer Center, Buffalo, United States
Elias Mai
Heidelberg Myeloma Center, Internal Medicine V, Hematology, Oncology and Rheumatology, Heidelberg University Hospital, Heidelberg, Germany
Salomon Manier
Tom Martin
UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA
María-Victoria Mateos
Hira Mian
Department of Oncology, McMaster University, Hamilton, ON, Canada
Joseph Mikhael
2Translational Genomics Research Institute, City of Hope Cancer Center, Phoenix, United States
Philippe Moreau
Nikhil C. Munshi
Bruno Paiva
Charlotte Pawlyn
Leo Rasche
University Hospital of Würzburg, Würzburg, Germany
Joshua Richter
Mount Sinai Medical Center, New York
Jesus San Miguel
5Cancer Center Clinica Universidad de Navarra, Centro de Investigación Médica Aplicada Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
Douglas W. Sborov
5Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT
Saad Z. Usmani
Memorial Sloan Kettering Cancer Center, New York
Meletios A. Dimopoulos
Elena Zamagni