A multicenter study of progression risk and outcomes in solitary bone plasmacytoma with and without marrow involvement.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Lim Kenneth J C, Steinhardt Maximilian, Rees Matthew J, Greipp Patricia, Kelemen Katalin, Dispenzieri Angela, Jevremovic Dragan, Baughn Linda, Buadi Francis K, Dingli David, Hayman Suzanne R, Kapoor Prashant, Muchtar Eli, Leung Nelson, Fonder Amie, Hobbs Miriam, Hwa Yi Lisa, Warsame Rahma, Kourelis Taxiarchis V, Cook Joselle, Binder Moritz, Abdallah Nadine, Zanwar Saurabh, Lin Yi, Go Ronald S, Siddiqui Mustaqeem A, Parrondo Ricardo D, Ailawadi Sikander, Roy Vivek, Cooke Rachel, Dun Karen, Zordan Adrian, Ninkovic Slavisa, Best Sharene H, Alatorre Gabriela A, Wiedmeier-Nutor J E, Kortum K Martin, Einsele Hermann, Chhabra Saurabh, Bergsagel P Leif, Kyle Robert A, Gertz Morie A, Kumar Shaji K, Rajkumar S Vincent, Fonseca Rafael, Gonsalves Wilson I, Yadav Udit
Аннотация
Solitary bone plasmacytoma (SBP) and SBP with minimal marrow involvement (SBPmm) are treated similarly with definitive radiation therapy (RT) followed by observation. However, differences in the natural disease course after RT between the two, are not well described. We performed a multicenter study assessing outcomes after RT in 141 patients with SBP and 102 with SBPmm diagnosed between January 2010 and December 2024. About 92% of patients with SBPmm progressed to multiple myeloma (MM) vs 76% of those with SBP (P = .01). Among patients with SBP, 21% progressed with a second solitary bone lesion vs 4% with SBPmm (P< .01). Patients with longer time to progression (TTP) after initial RT could achieve durable responses with RT to a second solitary plasmacytoma in the absence of other myeloma-defining events (MDE). Multifocal lytic bone lesions were the most common MDE, occurring in 89% and 81% of patients with SBPmm and SBP, respectively. Patients with SBPmm had a median TTP of 15 months (95% confidence interval [CI], 14-21) compared to 43 months (95% CI, 34-55) for those with SBP (P< .0001); 67% with SBPmm progressed within 2 years of diagnosis. Del(17p) and 1q+ (gain or amplification) were associated with shorter TTP to MM in SBPmm, with 2-year progression rates of 100% and 82%, respectively. We report significant differences in risk and modes of progression between SBP and SBPmm. Patients with SBPmm are at particularly high risk for early progression to MM, with most developing bone disease as the MDE. These findings support prospective studies incorporating frontline systemic therapy for SBPmm.