A multi-center study of progression-risk and outcomes in solitary bone plasmacytoma with and without marrow involvement

Solitary bone plasmacytoma (SBP) and Solitary bone plasmacytoma with minimal marrow involvement (SBPmm) are treated similarly, with definitive radiation therapy (RT) followed by observation. However, the distinction in the natural disease course after RT between the two is not well described. We performed a multi-center study assessing post RT outcomes in 141 SBP and 102 SBPmm patients diagnosed between January 2010 and December 2024. 92% of SBPmm patients progressed to multiple myeloma (MM) vs 76% in patients with SBP (p=0.01); 21% of progressions from SBP were with another solitary bone lesion vs 4% in SBPmm (p <0.01). Patients with a long time to progression (TTP) post first RT had durable responses with RT to the second solitary plasmacytoma in the absence of other myeloma-defining events (MDE). Multi-focal lytic bone lesions were the most common MDE, in 89% and 81% of SBPmm and SBP patients, respectively. SBPmm patients had a median TTP of 15 months (95% CI 14-21) compared to 43 months (95% CI, 34-55) in SBP patients (p<0.0001), with 67% SBPmm patients progressing within 2 years of diagnosis. Del(17p) and 1q+ (gain or amplification) predicted for shorter TTP to MM in SBPmm, with 2-year progression rates of 100% and 82%, respectively. We report significant differences in the risk and modes of progression between SBP and SBPmm. SBPmm patients are at particularly high risk for early progression to MM, with majority developing bone disease as the MDE. These findings support exploring prospective studies that incorporate frontline systemic therapy for SBPmm patients.

Authors

Institutions

Publication Details

Journal
Blood Advances
Published
2026-04-22
DOI
https://doi.org/10.1182/bloodadvances.2025019136
Primary Topic
Multiple Myeloma Research and Treatments
Type
article
Field-Weighted Citation Impact
0.00

Funders

Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

A multi-center study of progression-risk and outcomes in solitary bone plasmacytoma with and without marrow involvement

Angela A. Dispenzieri, P. Leif Bergsagel, Francis K. Buadi, Nelson Leung et al.
Blood Advances
Multiple Myeloma Research and Treatments
article

A multi-center study of progression-risk and outcomes in solitary bone plasmacytoma with and without marrow involvement

Angela A. Dispenzieri, P. Leif Bergsagel, Francis K. Buadi, Nelson Leung, Slavisa Ninkovic, Maximilian Steinhardt, Shaji Kunnathu Kumar, Saurabh Chhabra, Prashant Kapoor, Linda Banovic Baughn, Amie Fonder, Moritz Binder, Ricardo Parrondo, Y. Hwa, Rahma Warsame, Kenneth J C Lim, Joselle Cook, Matthew J. Rees, K. Martin Kortüm, Mustaqeem Siddiqui, Rachel E. Cooke, Patricia T. Greipp, Taxiarchis Kourelis, Saurabh Zanwar, Eli Muchtar, Vivek Roy, K. Dun, MA Gertz, Sharene Best, Suzanne R. Hayman, Katalin Kelemen, Gabriela Alatorre, Julia Erin Wiedmeier-Nutor, Rafael Fonseca, Nadine Abdallah, H Einsele, S Vincent Rajkumar, Udit Yadav, Ronald S. Go, Robert A Kyle, Wilson I Gonsalves, Adrian Carl Zordan, Dragan Jevremovic, Yi Lin, Sikander Ailawadhi, Miriam A Hobbs, David Dingli
article en

Abstract

Solitary bone plasmacytoma (SBP) and Solitary bone plasmacytoma with minimal marrow involvement (SBPmm) are treated similarly, with definitive radiation therapy (RT) followed by observation. However, the distinction in the natural disease course after RT between the two is not well described. We performed a multi-center study assessing post RT outcomes in 141 SBP and 102 SBPmm patients diagnosed between January 2010 and December 2024. 92% of SBPmm patients progressed to multiple myeloma (MM) vs 76% in patients with SBP (p=0.01); 21% of progressions from SBP were with another solitary bone lesion vs 4% in SBPmm (p <0.01). Patients with a long time to progression (TTP) post first RT had durable responses with RT to the second solitary plasmacytoma in the absence of other myeloma-defining events (MDE). Multi-focal lytic bone lesions were the most common MDE, in 89% and 81% of SBPmm and SBP patients, respectively. SBPmm patients had a median TTP of 15 months (95% CI 14-21) compared to 43 months (95% CI, 34-55) in SBP patients (p<0.0001), with 67% SBPmm patients progressing within 2 years of diagnosis. Del(17p) and 1q+ (gain or amplification) predicted for shorter TTP to MM in SBPmm, with 2-year progression rates of 100% and 82%, respectively. We report significant differences in the risk and modes of progression between SBP and SBPmm. SBPmm patients are at particularly high risk for early progression to MM, with majority developing bone disease as the MDE. These findings support exploring prospective studies that incorporate frontline systemic therapy for SBPmm patients.

Blood Advances
Mayo Clinic (US), Jacksonville College (US), WinnMed (US), Northern Hospital (AU), St Vincent's Hospital Melbourne (AU), Cancer Australia (AU), St Vincent's Health (AU), Mayo Clinic in Arizona (US), Universitätsklinikum Würzburg (DE), Mayo Clinic Hospital (US), Mayo Clinic in Florida (US)
National Cancer Institute
Openalex Percentile: Top 9%
Multiple Myeloma Research and Treatments
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.