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Improved outcome in solitary bone plasmacytomata with combined therapy.
Hematol Oncol. 1996 Sep; 14(3):111-7.HO

Abstract

Solitary bone plasmacytoma (SBP) is a rare presentation of plasma cell dyscrasias. Radiotherapy has been considered the treatment of choice, however, most patients will develop multiple myeloma, 3 to 10 years after initial diagnosis and treatment. No innovations have been introduced in the treatment of SBP in the last 30 years. We began a prospective clinical trial to assess the efficacy and toxicity of adjuvant chemotherapy with low doses of melphalan and prednisone administered to patients with SBP after radiation therapy in an attempt to improve the disease-free survival and overall survival. Between 1982 and 1989, 53 patients with SBP were randomly assigned to be treated with either local radiotherapy with doses ranged from 4000 to 5000 cGy to achieve local control of disease (28 patients) or the same radiotherapy schedule followed by melphalan and prednisone given every 6 weeks for 3 years (25 patients). After a median follow-up of 8.9 years, disease-free survival and overall survival were improved in patients who were treated with combined therapy, 22 patients remain alive and free of disease in the combined treatment group compared to only 13 patients in the radiotherapy group (p < 0.01). Treatment was well tolerated; planned doses were administered in all cases; no delays in treatment or acute side-effects were observed during treatment. Long-term secondary toxicities including secondary neoplasms and acute leukaemia, have not been observed. We felt that the use of adjuvant chemotherapy after adequate doses of radiotherapy in patients with SBP improved duration of remission and survival without severe side-effects. However, as with other studies in SBP, the group was too small to draw definitive conclusions and more controlled clinical trials are necessary to define the role of this therapeutic approach in patients with SBP.

Authors+Show Affiliations

Department of Hematology, Oncology Hospital, National Medical Center, México, D.F. Mexico, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

9119355

Citation

Avilés, A, et al. "Improved Outcome in Solitary Bone Plasmacytomata With Combined Therapy." Hematological Oncology, vol. 14, no. 3, 1996, pp. 111-7.
Avilés A, Huerta-Guzmán J, Delgado S, et al. Improved outcome in solitary bone plasmacytomata with combined therapy. Hematol Oncol. 1996;14(3):111-7.
Avilés, A., Huerta-Guzmán, J., Delgado, S., Fernández, A., & Díaz-Maqueo, J. C. (1996). Improved outcome in solitary bone plasmacytomata with combined therapy. Hematological Oncology, 14(3), 111-7.
Avilés A, et al. Improved Outcome in Solitary Bone Plasmacytomata With Combined Therapy. Hematol Oncol. 1996;14(3):111-7. PubMed PMID: 9119355.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Improved outcome in solitary bone plasmacytomata with combined therapy. AU - Avilés,A, AU - Huerta-Guzmán,J, AU - Delgado,S, AU - Fernández,A, AU - Díaz-Maqueo,J C, PY - 1996/9/1/pubmed PY - 2000/6/20/medline PY - 1996/9/1/entrez SP - 111 EP - 7 JF - Hematological oncology JO - Hematol Oncol VL - 14 IS - 3 N2 - Solitary bone plasmacytoma (SBP) is a rare presentation of plasma cell dyscrasias. Radiotherapy has been considered the treatment of choice, however, most patients will develop multiple myeloma, 3 to 10 years after initial diagnosis and treatment. No innovations have been introduced in the treatment of SBP in the last 30 years. We began a prospective clinical trial to assess the efficacy and toxicity of adjuvant chemotherapy with low doses of melphalan and prednisone administered to patients with SBP after radiation therapy in an attempt to improve the disease-free survival and overall survival. Between 1982 and 1989, 53 patients with SBP were randomly assigned to be treated with either local radiotherapy with doses ranged from 4000 to 5000 cGy to achieve local control of disease (28 patients) or the same radiotherapy schedule followed by melphalan and prednisone given every 6 weeks for 3 years (25 patients). After a median follow-up of 8.9 years, disease-free survival and overall survival were improved in patients who were treated with combined therapy, 22 patients remain alive and free of disease in the combined treatment group compared to only 13 patients in the radiotherapy group (p < 0.01). Treatment was well tolerated; planned doses were administered in all cases; no delays in treatment or acute side-effects were observed during treatment. Long-term secondary toxicities including secondary neoplasms and acute leukaemia, have not been observed. We felt that the use of adjuvant chemotherapy after adequate doses of radiotherapy in patients with SBP improved duration of remission and survival without severe side-effects. However, as with other studies in SBP, the group was too small to draw definitive conclusions and more controlled clinical trials are necessary to define the role of this therapeutic approach in patients with SBP. SN - 0278-0232 UR - https://www.unboundmedicine.com/medline/citation/9119355/Improved_outcome_in_solitary_bone_plasmacytomata_with_combined_therapy_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=0278-0232&amp;date=1996&amp;volume=14&amp;issue=3&amp;spage=111 DB - PRIME DP - Unbound Medicine ER -