Journal of Clinical Oncology, Vol 10, 587-590, Copyright © 1992 by American Society of Clinical Oncology
Curability of solitary bone plasmacytoma
MA Dimopoulos, J Goldstein, L Fuller, K Delasalle and R Alexanian
University of Texas M.D. Anderson Cancer Center, Houston 77030.
PURPOSE: The effects of involved-field radiotherapy were assessed in
patients with a solitary plasmacytoma of bone (SBP). PATIENTS AND METHODS:
Forty-five consecutive patients with an SBP received megavoltage
irradiation of at least 3,000 cGy. The median age was 53 years, 67% of
patients showed a myeloma protein, and uninvolved immunoglobulins (Igs)
were preserved in 93% of patients. RESULTS: Permanent control of presenting
disease was achieved in all but two patients, but 46% of patients developed
multiple myeloma. When it occurred, progression of myeloma occurred within
3 years in two thirds of the patients, suggesting that the extent of
disease was understaged at diagnosis. Myeloma protein disappeared in nine
patients (30%) whose disease has not yet recurred. The median survival for
all patients was 13 years and the myeloma-specific survival fraction at 10
years was 53%. CONCLUSION: In patients with an SBP, the disappearance of
myeloma protein with involved-field radiotherapy predicted long-term
disease- free survival and possible cure. Nonsecretory disease and
persistent myeloma protein after treatment were adverse prognostic factors
for which adjuvant therapy with interferon alfa should be considered.
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