Characteristics and Survival Outcomes of Solitary Plasmacytomas: A 30‐Year Experience of the Greek Myeloma Study Group on 175 Patients

In this multi-institutional retrospective study, we analyzed the characteristics and outcomes of 118 patients with solitary bone plasmacytoma (SBP) and 57 with extramedullary plasmacytoma (SEP) diagnosed over 30 years. We also evaluated the impact of systemic therapy (ST), which is not routinely recommended, compared to standard radiation therapy (RT). The median age was 62 years (range: 17-85). Treatment included RT (n = 94), RT with ST (n = 47), ST alone (n = 22), and surgical excision alone (n = 12). Overall and complete response (CR) rates were 93% and 53%, respectively; 70 patients relapsed, 56 progressing to multiple myeloma (MM). The median follow-up was 10 years (95% CI: 7.1-13). Median estimated overall survival (OS) was 18.5 years with a 5- and 10-year OS rate of 85% and 70%, respectively, similar across groups (p > 0.05). Median progression-free survival (PFS) was 75 months (95% CI: 53-97), with a 5- and 10-year PFS rates of 57% and 44%. The 5- and 10-year MM-free survival (MMFS) was 66% and 53%, respectively. We identified age ≤ 60 years, achieving CR, and an abnormal serum FLC ratio at diagnosis as the strongest prognosticators for OS (HR: 0.25), PFS (HR: 0.54), and MMFS (HR: 5 + 0.4), respectively (p < 0.05); ST alone or combined with RT did not significantly improve survival outcomes or MMFS (p > 0.05). In conclusion, ST increased toxicity without offering outcome benefits, reaffirming RT as the cornerstone of SP management. Despite therapeutic advancements in MM, the persistent challenge of progression to MM underscores the importance of identifying high-risk SP patients, enabling early intervention with more aggressive treatments.

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Journal
American Journal of Hematology
Published
2025-06-03
DOI
https://doi.org/10.1002/ajh.27725
Citations
3
Primary Topic
Multiple Myeloma Research and Treatments
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article
Field-Weighted Citation Impact
5.31
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article

Characteristics and Survival Outcomes of Solitary Plasmacytomas: A 30‐Year Experience of the Greek Myeloma Study Group on 175 Patients

Vasiliki Pappa, Evgenia Verrou, Dionisios Stoumbos, Efstathios Kastritis et al.
3 citations
American Journal of Hematology
Multiple Myeloma Research and Treatments
5.31
article

Characteristics and Survival Outcomes of Solitary Plasmacytomas: A 30‐Year Experience of the Greek Myeloma Study Group on 175 Patients

Vasiliki Pappa, Evgenia Verrou, Dionisios Stoumbos, Efstathios Kastritis, Emmanouil Spanoudakis, Annita Ioanna Gkioka, Ioannis Ntanasis‐Stathopoulos, Meletios Α. Dimopoulos, Sotirios G. Papageorgiou, Eirini Katodritou, Evangelos Terpos, Anastasia Pouli, Nikolaos Kanellias, Aikaterini Daiou, Maria Kotsopoulou, Dimitra Dalampira, Marie‐Christine Kyrtsonis, Foteini Theodorakakou, Vasiliki Labropoulou, Kyriaki Tsirou, Avgi Lalayianni, Theodosia Papadopoulou, Sosana Delimpasi, Maria Gavriatopoulou, Despina Fotiou, Theodora Triantafyllou, Nikolaos Giannakoulas, Aggeliki Sevastoudi, Gerasimos Kyriakidis, Vasiliki Douka
article en
3 citations

Abstract

In this multi-institutional retrospective study, we analyzed the characteristics and outcomes of 118 patients with solitary bone plasmacytoma (SBP) and 57 with extramedullary plasmacytoma (SEP) diagnosed over 30 years. We also evaluated the impact of systemic therapy (ST), which is not routinely recommended, compared to standard radiation therapy (RT). The median age was 62 years (range: 17-85). Treatment included RT (n = 94), RT with ST (n = 47), ST alone (n = 22), and surgical excision alone (n = 12). Overall and complete response (CR) rates were 93% and 53%, respectively; 70 patients relapsed, 56 progressing to multiple myeloma (MM). The median follow-up was 10 years (95% CI: 7.1-13). Median estimated overall survival (OS) was 18.5 years with a 5- and 10-year OS rate of 85% and 70%, respectively, similar across groups (p > 0.05). Median progression-free survival (PFS) was 75 months (95% CI: 53-97), with a 5- and 10-year PFS rates of 57% and 44%. The 5- and 10-year MM-free survival (MMFS) was 66% and 53%, respectively. We identified age ≤ 60 years, achieving CR, and an abnormal serum FLC ratio at diagnosis as the strongest prognosticators for OS (HR: 0.25), PFS (HR: 0.54), and MMFS (HR: 5 + 0.4), respectively (p < 0.05); ST alone or combined with RT did not significantly improve survival outcomes or MMFS (p > 0.05). In conclusion, ST increased toxicity without offering outcome benefits, reaffirming RT as the cornerstone of SP management. Despite therapeutic advancements in MM, the persistent challenge of progression to MM underscores the importance of identifying high-risk SP patients, enabling early intervention with more aggressive treatments.

American Journal of HematologyVol. 100(8)
University of Thessaly (GR), University of Patras (GR), Korea University (KR), National and Kapodistrian University of Athens (GR), Korea University Medical Center (KR), Theageneio General Hospital (GR), Laiko General Hospital of Athens (GR), St Savas Hospital (GR), Metaxa Hospital (GR), University General Hospital Attikon (GR), G. Papanikolaou General Hospital (GR), University Hospital of Alexandroupolis (GR), Evangelismos Hospital (GR)
Openalex Percentile: Top 5%
Multiple Myeloma Research and Treatments
5.31
DOISourceOpenAlex
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