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How We Manage Patients with Plasmacytomas.

Despina Fotiou¹, Meletios A Dimopoulos¹, Efstathios Kastritis²

¹Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Current Hematologic Malignancy Reports

|April 19, 2018

Summary

This review covers solitary plasmacytomas (SP) and their management within multiple myeloma (MM). Advanced imaging aids diagnosis, while radiotherapy is key for SP, with systemic therapy for relapse.

Keywords:

Bone disease Extramedullary Plasma cells Solitary lesion Tumor

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Area of Science:

Hematology
Oncology
Radiology

Background:

Plasmacytomas, including solitary plasmacytomas (SP) and those within multiple myeloma (MM), require precise diagnostic and therapeutic strategies.
Understanding the distinct biological characteristics of extramedullary clonal plasma cells is crucial for patient outcomes.

Purpose of the Study:

To review the diagnostic approach for plasmacytomas.
To outline current treatment options for solitary plasmacytomas and related conditions.
To discuss future directions in managing plasmacytomas and multiple myeloma.

Main Methods:

Review of advanced imaging techniques (e.g., whole-body MRI, PET/CT) for diagnosing solitary plasmacytomas.
Evaluation of prognostic factors and diagnostic tools like flow cytometry for risk stratification.
Analysis of treatment outcomes for radiotherapy and systemic therapies.

Main Results:

Advanced imaging is vital to exclude disseminated disease in solitary plasmacytomas.
Local radiotherapy is effective for solitary plasmacytomas, but systemic therapy is needed for relapsed disease.
Extramedullary plasmacytomas in MM indicate ultra-high risk and poor prognosis.

Conclusions:

A revised definition of solitary plasmacytoma is needed to guide therapy and follow-up.
Further research is required to optimize treatment for patients with paraskeletal or extramedullary disease in MM.