Journal ArticleDOI
Solitary bone plasmacytoma: outcome and prognostic factors following radiotherapy
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TLDR
Results supported the importance of precise staging that includes MRI of the spine for optimum patient selection and the application of definitive radiotherapy and showed those patients with myeloma protein that disappears following radiotherapy represent a category with a high likelihood of cure.Abstract:
Purpose: To clarify the natural history of solitary plasmacytoma of bone (SBP) after radiation treatment. Methods and Materials: Between 1965–1996, we identified 57 previously untreated patients with a SBP. A serum myeloma protein was present in 33 patients (58%) and Bence Jones proteinuria was present in an additional eight patients (14%). The median radiotherapy dose was 50 Gy (range, 30–70 Gy). Overall survival, cause-specific survival, and freedom from progression to multiple myeloma were calculated actuarially. Results: Local control was achieved in 55 of 57 patients (96%). For those 29 patients (51%) who subsequently developed multiple myeloma, the median time to progression was 1.8 years. There was a direct correlation between persistence of abnormal protein following radiotherapy and the likelihood of developing multiple myeloma. Among 11 patients with disappearance of myeloma protein, only two developed multiple myeloma after 4 and 12 years, in contrast to progression in 57% of patients with a persistent protein peak and 63% of those with nonsecretory disease ( p = 0.02). Among 23 patients with thoracolumbar spine disease, 7 of 8 patients staged with plain radiographs alone developed multiple myeloma in comparison with 1 of 7 patients who also had magnetic resonance imaging (MRI) ( p = 0.08). For all patients, the median survival from radiotherapy was 11.0 years. The median cause-specific survival of patients with disappearance of myeloma protein was significantly longer than that of the remaining patients ( p = 0.004). Conclusion: Results supported the importance of precise staging that includes MRI of the spine for optimum patient selection and the application of definitive radiotherapy. Those patients with myeloma protein that disappears following radiotherapy represent a category with a high likelihood of cure.read more
Citations
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Pathology and genetics of tumors of soft tissue and bone
TL;DR: This list includes tumours of undefined neoplastic nature, which are of uncertain differentiation Bone Tumours, Ewing sarcoma/Primitive neuroedtodermal tumour, Myogenic, lipogenic, neural and epithelial tumours, and others.
Journal ArticleDOI
Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders: a report of the International Myeloma Working Group
Robert A. Kyle,J. Anthony Child,Kenneth C. Anderson,Bart Barlogie,Régis Bataille,William I. Bensinger,Joan Bladé,Mario Boccadoro,William S. Dalton,Meletios A. Dimopoulos,Benjamin Djulbegovic,Mark T. Drayson,Brian G.M. Durie,Thiery Facon,Rafael Fonseca,Gösta Gahrton,Philip R. Greipp,Jean Luc Harousseau,David P. Harrington,Mohamad A. Hussein,Douglas E. Joshua,Heinz Ludwig,Gareth J. Morgan,Martin M. Oken,R. L. Powles,Paul G. Richardson,David Roodman,Jesús F. San Miguel,Kazuyuki Shimizu,Chaim Shustik,Bhawna Sirohi,Pieter Sonneveld,Guido J Tricot,Ingemar Turesson,Brian G Van Ness,David H. Vesole,Donna M. Weber,Jan Westin,Keith Wheatley +38 more
TL;DR: The International Myeloma Working Group has reviewed the criteria for diagnosis and classification with the aim of producing simple, easily used definitions based on routinely available investigations to facilitate comparison of therapeutic trial data.
Journal ArticleDOI
Guidelines on the diagnosis and management of solitary plasmacytoma of bone and solitary extramedullary plasmacytoma.
TL;DR: SBP and SEP are rare diseases and most of the evidence relates to retrospective data from patient series collected over long periods of time, so the majority of the recommendations given are based on consensus of expert.
Journal ArticleDOI
International myeloma working group consensus statement and guidelines regarding the current role of imaging techniques in the diagnosis and monitoring of multiple Myeloma.
Meletios A. Dimopoulos,Evangelos Terpos,Raymond L. Comenzo,Patrizia Tosi,Meral Beksac,Orhan Sezer,David S. Siegel,Henk M. Lokhorst,Shaji Kumar,S V Rajkumar,Ruben Niesvizky,Lia A. Moulopoulos,Brian G.M. Durie +12 more
TL;DR: Bone scintigraphy has no place in the routine staging of myeloma, whereas sequential dual-energy X-ray absorptiometry scans are not recommended, and Positron emission tomography/CT or MIBI imaging are also not recommended for routine use in the management of Myeloma patients.
Journal ArticleDOI
Role of 18F-FDG PET/CT in the diagnosis and management of multiple myeloma and other plasma cell disorders: a consensus statement by the International Myeloma Working Group
Michele Cavo,Evangelos Terpos,Cristina Nanni,Philippe Moreau,Suzanne Lentzsch,Sonja Zweegman,Jens Hillengass,Monika Engelhardt,Saad Z. Usmani,David H. Vesole,Jesús F. San-Miguel,Shaji Kumar,Paul G. Richardson,Joseph R. Mikhael,Fernando Leal da Costa,Meletios A. Dimopoulos,Chiara Zingaretti,Niels Abildgaard,Hartmut Goldschmidt,Robert Z. Orlowski,Wee Joo Chng,Hermann Einsele,Sagar Lonial,Bart Barlogie,Kenneth C. Anderson,S. Vincent Rajkumar,Brian G.M. Durie,Elena Zamagni +27 more
TL;DR: Based on the ability of 18F-FDG PET/CT to distinguish between metabolically active and inactive disease, this technique is now the preferred functional imaging modality to evaluate and to monitor the effect of therapy on myeloma-cell metabolism.
References
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Book ChapterDOI
Nonparametric Estimation from Incomplete Observations
Edward L. Kaplan,Paul Meier +1 more
TL;DR: In this article, the product-limit (PL) estimator was proposed to estimate the proportion of items in the population whose lifetimes would exceed t (in the absence of such losses), without making any assumption about the form of the function P(t).
Journal ArticleDOI
The natural history of extramedullary plasmacytoma and its relation to solitary myeloma of bone and myelomatosis.
TL;DR: It is concluded that extramedullary plasmacytoma (EMP) shows several important differences from myelomatosis and solitary myeloma of bone (SMB) which can be summarized as follows: A marked preference for the primary tumor to present in a particular site, namely the upper air passages.
Journal ArticleDOI
Promiscuous translocations into immunoglobulin heavy chain switch regions in multiple myeloma
P. Leif Bergsagel,Marta Chesi,Elena Nardini,Leslie A. Brents,Suzanne L. Kirby,W. Michael Kuehl +5 more
TL;DR: It is suggested that translocations into the IgH locus are frequent and occur mainly in switch regions; and involve a diverse but nonrandom array of chromosomal partners.
Journal ArticleDOI
Comparison of extramedullary plasmacytomas with solitary and multiple plasma cell tumors of bone.
TL;DR: In EMP patients the occurrence of involved lymph nodes at the time of diagnosis in seven, and initial relapse in regional nodes in three, suggest that consideration should be given to including regional lymph nodes in the radiation fields used to treat these patients.
Journal ArticleDOI
VAD-based regimens as primary treatment for multiple myeloma.
TL;DR: An alternating VCAD‐VAD regimen, combining vincristine‐doxorubicin by continuous infusion with cyclophosphamide and pulse dexamethasone, or VAD alone was given to 175 previously untreated patients with multiple myeloma.
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