Multiple Myeloma Treatment Information for Healthcare Professionals

Isolated Plasmacytoma of Bone

If a solitary lytic lesion of plasma cells is found on skeletal survey in an otherwise asymptomatic patient, and a bone marrow examination from an uninvolved site contains less than 5% plasma cells, the patient has an isolated plasmacytoma of bone. The survival of patients with isolated plasmacytoma of bone treated with radiation of the lesion is over 50% at 10 years, which is much better than the survival with disseminated multiple myeloma. Most patients will eventually develop disseminated disease and require chemotherapy; almost half will have done so within 2 years of diagnosis.^1,2 However, those patients with low levels of serum paraprotein (<1.0 gram per deciliter) or Bence-Jones protein who have complete disappearance of these proteins may be expected to remain free of disease for prolonged periods.³ Patients who progress to multiple myeloma tend to have good responses to chemotherapy with a median survival of 63 months after progression.³

Treatment options:

1. Tumoricidal irradiation of the lesion.
   
2. If the M-protein increases and other evidence of symptomatic multiple myeloma occurs, chemotherapy is required.

References:

1. Chak LY, Cox RS, Bostwick DG, et al.: Solitary plasmacytoma of bone: treatment, progression, and survival. Journal of Clinical Oncology 5(11): 1811-1815, 1987.
2. Knowling MA, Harwood AR, Bergsagel DE: Comparison of extramedullary plasmacytomas with solitary and multiple plasma cell tumors of bone. Journal of Clinical Oncology 1(4): 255-262, 1983.
3. Dimopoulos MA, Goldstein J, Fuller L, et al.: Curability of solitary bone plasmacytoma. Journal of Clinical Oncology 10(4): 587-590, 1992.

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