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Impact of initial FDG-PET/CT and serum-free light chain on transformation of conventionally defined solitary plasmacytoma to multiple myeloma.
Clin Cancer Res. 2014 Jun 15; 20(12):3254-60.CC

Abstract

PURPOSE

Solitary plasmacytoma (SP) is a localized proliferation of monoclonal plasma cells in either bone or soft tissue, without evidence of multiple myeloma (MM), and whose prognosis is marked by a high risk of transformation to MM.

EXPERIMENTAL DESIGN

We studied the impact of FDG-PET/CT (2[18F]fluoro-2-deoxy-D-glucose positron emission tomography-computed tomography) on the risk of transformation of SP to overt MM among other markers in a series of 43 patients diagnosed with SP.

RESULTS

Median age was 57.5 years; 48% of patients had an abnormal involved serum-free light chain (sFLC) value, and 64% had an abnormal sFLC ratio at diagnosis. Thirty-three percent had two or more hypermetabolic lesions on initial PET/CT, and 20% had two or more focal lesions on initial MRI. With a median follow-up of 50 months, 14 patients transformed to MM with a median time (TTMM) of 71 months. The risk factors that significantly shortened TTMM at diagnosis were two or more hypermetabolic lesions on PET/CT, abnormal sFLC ratio and involved sFLC, and to a lesser extent at completion of treatment, absence of normalized involved sFLC and PET/CT or MRI. In a multivariate analysis, abnormal initial involved sFLC [OR = 10; 95% confidence interval (CI), 1-87; P = 0.008] and PET/CT (OR = 5; 95% CI, 0-9; P = 0.032) independently shortened TTMM.

CONCLUSIONS

An abnormal involved sFLC value and the presence of at least two hypermetabolic lesions on PET/CT at diagnosis of SP were the two predictors of early evolution to myeloma in our series. This data analysis will need confirmation in a larger study, and the study of these two risk factors may lead to a different management of patients with SP in the future. .

Authors+Show Affiliations

Authors' Affiliations: Service des maladies du sang; Médecine nucléaire, Hôpital Huriez, CHRU, Lille; Hématologie, Hôpital Côte de Nacre, CHU, Caen; Hématologie, Hôpital Sud, CHU, Rennes, France.Authors' Affiliations: Service des maladies du sang; Médecine nucléaire, Hôpital Huriez, CHRU, Lille; Hématologie, Hôpital Côte de Nacre, CHU, Caen; Hématologie, Hôpital Sud, CHU, Rennes, France.Authors' Affiliations: Service des maladies du sang; Médecine nucléaire, Hôpital Huriez, CHRU, Lille; Hématologie, Hôpital Côte de Nacre, CHU, Caen; Hématologie, Hôpital Sud, CHU, Rennes, France.Authors' Affiliations: Service des maladies du sang; Médecine nucléaire, Hôpital Huriez, CHRU, Lille; Hématologie, Hôpital Côte de Nacre, CHU, Caen; Hématologie, Hôpital Sud, CHU, Rennes, France.Authors' Affiliations: Service des maladies du sang; Médecine nucléaire, Hôpital Huriez, CHRU, Lille; Hématologie, Hôpital Côte de Nacre, CHU, Caen; Hématologie, Hôpital Sud, CHU, Rennes, France.Authors' Affiliations: Service des maladies du sang; Médecine nucléaire, Hôpital Huriez, CHRU, Lille; Hématologie, Hôpital Côte de Nacre, CHU, Caen; Hématologie, Hôpital Sud, CHU, Rennes, France.Authors' Affiliations: Service des maladies du sang; Médecine nucléaire, Hôpital Huriez, CHRU, Lille; Hématologie, Hôpital Côte de Nacre, CHU, Caen; Hématologie, Hôpital Sud, CHU, Rennes, France.Authors' Affiliations: Service des maladies du sang; Médecine nucléaire, Hôpital Huriez, CHRU, Lille; Hématologie, Hôpital Côte de Nacre, CHU, Caen; Hématologie, Hôpital Sud, CHU, Rennes, France.Authors' Affiliations: Service des maladies du sang; Médecine nucléaire, Hôpital Huriez, CHRU, Lille; Hématologie, Hôpital Côte de Nacre, CHU, Caen; Hématologie, Hôpital Sud, CHU, Rennes, France.Authors' Affiliations: Service des maladies du sang; Médecine nucléaire, Hôpital Huriez, CHRU, Lille; Hématologie, Hôpital Côte de Nacre, CHU, Caen; Hématologie, Hôpital Sud, CHU, Rennes, France.Authors' Affiliations: Service des maladies du sang; Médecine nucléaire, Hôpital Huriez, CHRU, Lille; Hématologie, Hôpital Côte de Nacre, CHU, Caen; Hématologie, Hôpital Sud, CHU, Rennes, France.Authors' Affiliations: Service des maladies du sang; Médecine nucléaire, Hôpital Huriez, CHRU, Lille; Hématologie, Hôpital Côte de Nacre, CHU, Caen; Hématologie, Hôpital Sud, CHU, Rennes, France.Authors' Affiliations: Service des maladies du sang; Médecine nucléaire, Hôpital Huriez, CHRU, Lille; Hématologie, Hôpital Côte de Nacre, CHU, Caen; Hématologie, Hôpital Sud, CHU, Rennes, France.Authors' Affiliations: Service des maladies du sang; Médecine nucléaire, Hôpital Huriez, CHRU, Lille; Hématologie, Hôpital Côte de Nacre, CHU, Caen; Hématologie, Hôpital Sud, CHU, Rennes, France.Authors' Affiliations: Service des maladies du sang; Médecine nucléaire, Hôpital Huriez, CHRU, Lille; Hématologie, Hôpital Côte de Nacre, CHU, Caen; Hématologie, Hôpital Sud, CHU, Rennes, France.Authors' Affiliations: Service des maladies du sang; Médecine nucléaire, Hôpital Huriez, CHRU, Lille; Hématologie, Hôpital Côte de Nacre, CHU, Caen; Hématologie, Hôpital Sud, CHU, Rennes, France.Authors' Affiliations: Service des maladies du sang; Médecine nucléaire, Hôpital Huriez, CHRU, Lille; Hématologie, Hôpital Côte de Nacre, CHU, Caen; Hématologie, Hôpital Sud, CHU, Rennes, France.Authors' Affiliations: Service des maladies du sang; Médecine nucléaire, Hôpital Huriez, CHRU, Lille; Hématologie, Hôpital Côte de Nacre, CHU, Caen; Hématologie, Hôpital Sud, CHU, Rennes, France xavier.leleu@chru-lille.fr.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

24714772

Citation

Fouquet, Guillemette, et al. "Impact of Initial FDG-PET/CT and Serum-free Light Chain On Transformation of Conventionally Defined Solitary Plasmacytoma to Multiple Myeloma." Clinical Cancer Research : an Official Journal of the American Association for Cancer Research, vol. 20, no. 12, 2014, pp. 3254-60.
Fouquet G, Guidez S, Herbaux C, et al. Impact of initial FDG-PET/CT and serum-free light chain on transformation of conventionally defined solitary plasmacytoma to multiple myeloma. Clin Cancer Res. 2014;20(12):3254-60.
Fouquet, G., Guidez, S., Herbaux, C., Van de Wyngaert, Z., Bonnet, S., Beauvais, D., Demarquette, H., Adib, S., Hivert, B., Wemeau, M., Berthon, C., Terriou, L., Coiteux, V., Macro, M., Decaux, O., Facon, T., Huglo, D., & Leleu, X. (2014). Impact of initial FDG-PET/CT and serum-free light chain on transformation of conventionally defined solitary plasmacytoma to multiple myeloma. Clinical Cancer Research : an Official Journal of the American Association for Cancer Research, 20(12), 3254-60. https://doi.org/10.1158/1078-0432.CCR-13-2910
Fouquet G, et al. Impact of Initial FDG-PET/CT and Serum-free Light Chain On Transformation of Conventionally Defined Solitary Plasmacytoma to Multiple Myeloma. Clin Cancer Res. 2014 Jun 15;20(12):3254-60. PubMed PMID: 24714772.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of initial FDG-PET/CT and serum-free light chain on transformation of conventionally defined solitary plasmacytoma to multiple myeloma. AU - Fouquet,Guillemette, AU - Guidez,Stéphanie, AU - Herbaux,Charles, AU - Van de Wyngaert,Zoé, AU - Bonnet,Sarah, AU - Beauvais,David, AU - Demarquette,Hélène, AU - Adib,Salim, AU - Hivert,Bénédicte, AU - Wemeau,Mathieu, AU - Berthon,Céline, AU - Terriou,Louis, AU - Coiteux,Valérie, AU - Macro,Margaret, AU - Decaux,Olivier, AU - Facon,Thierry, AU - Huglo,Damien, AU - Leleu,Xavier, Y1 - 2014/04/08/ PY - 2014/4/10/entrez PY - 2014/4/10/pubmed PY - 2015/10/16/medline SP - 3254 EP - 60 JF - Clinical cancer research : an official journal of the American Association for Cancer Research JO - Clin. Cancer Res. VL - 20 IS - 12 N2 - PURPOSE: Solitary plasmacytoma (SP) is a localized proliferation of monoclonal plasma cells in either bone or soft tissue, without evidence of multiple myeloma (MM), and whose prognosis is marked by a high risk of transformation to MM. EXPERIMENTAL DESIGN: We studied the impact of FDG-PET/CT (2[18F]fluoro-2-deoxy-D-glucose positron emission tomography-computed tomography) on the risk of transformation of SP to overt MM among other markers in a series of 43 patients diagnosed with SP. RESULTS: Median age was 57.5 years; 48% of patients had an abnormal involved serum-free light chain (sFLC) value, and 64% had an abnormal sFLC ratio at diagnosis. Thirty-three percent had two or more hypermetabolic lesions on initial PET/CT, and 20% had two or more focal lesions on initial MRI. With a median follow-up of 50 months, 14 patients transformed to MM with a median time (TTMM) of 71 months. The risk factors that significantly shortened TTMM at diagnosis were two or more hypermetabolic lesions on PET/CT, abnormal sFLC ratio and involved sFLC, and to a lesser extent at completion of treatment, absence of normalized involved sFLC and PET/CT or MRI. In a multivariate analysis, abnormal initial involved sFLC [OR = 10; 95% confidence interval (CI), 1-87; P = 0.008] and PET/CT (OR = 5; 95% CI, 0-9; P = 0.032) independently shortened TTMM. CONCLUSIONS: An abnormal involved sFLC value and the presence of at least two hypermetabolic lesions on PET/CT at diagnosis of SP were the two predictors of early evolution to myeloma in our series. This data analysis will need confirmation in a larger study, and the study of these two risk factors may lead to a different management of patients with SP in the future. . SN - 1078-0432 UR - https://www.unboundmedicine.com/medline/citation/24714772/Impact_of_initial_FDG_PET/CT_and_serum_free_light_chain_on_transformation_of_conventionally_defined_solitary_plasmacytoma_to_multiple_myeloma_ L2 - http://clincancerres.aacrjournals.org/cgi/pmidlookup?view=long&pmid=24714772 DB - PRIME DP - Unbound Medicine ER -