Expert review on soft-tissue plasmacytomas in multiple myeloma: definition, disease assessment and treatment considerations

Rosinol L, Beksac M, Zamagni E, Van De Donk NWCJ, Anderson KC, Badros A, Caers J, Cavo M, Dimopoulos MA, Dispenzieri A, Einsele H, Engelhardt M, Fernandez De Larrea C, Gahrton G, Gay F, Hajek R, Hungria V, Jurczyszyn A, Kroeger N, Kyle RA, Leal Da Costa F, Leleu X, Lentzsch S, Mateos MV, Merlini G, Mohty M, Moreau P, Rasche L, Reece D, Sezer O, Sonneveld P, Usmani SZ, Vanderkerken K, Vesole DH, Waage A, Zweegman S, Richardson PG, Blade J (2021)

Publication Type: Journal article, Review article

Publication year: 2021

Journal

Book Volume: 194

Pages Range: 496-507

Journal Issue: 3

DOI: 10.1111/bjh.17338

Abstract

In this review, two types of soft-tissue involvement in multiple myeloma are defined: (i) extramedullary (EMD) with haematogenous spread involving only soft tissues and (ii) paraskeletal (PS) with tumour masses arising from skeletal lesions. The incidence of EMD and PS plasmacytomas at diagnosis ranges from 1·7% to 4·5% and 7% to 34·4% respectively. EMD disease is often associated with high-risk cytogenetics, resistance to therapy and worse prognosis than in PS involvement. In patients with PS involvement a proteasome inhibitor-based regimen may be the best option followed by autologous stem cell transplantation (ASCT) in transplant eligible patients. In patients with EMD disease who are not eligible for ASCT, a proteasome inhibitor-based regimen such as lenalidomide-bortezomib-dexamethasone (RVD) may be the best option, while for those eligible for high-dose therapy a myeloma/lymphoma-like regimen such as bortezomib, thalidomide and dexamethasone (VTD)-RVD/cisplatin, doxorubicin, cyclophosphamide and etoposide (PACE) followed by SCT should be considered. In both EMD and PS disease at relapse many strategies have been tried, but this remains a high-unmet need population.

Involved external institutions

Universitat de Barcelona (UB) / University of Barcelona Spain (ES) Ankara University / Ankara Üniversitesi Turkey (TR) University of Bologna / Università di Bologna Italy (IT) Vrije Universiteit Amsterdam (VU) / University Amsterdam Netherlands (NL) Harvard University United States (USA) (US) University of Maryland United States (USA) (US) Centre Hospitalier Universitaire de Liège (CHU Liège) Belgium (BE) National and Kapodistrian University of Athens Greece (GR) Mayo Clinic United States (USA) (US) Universitätsklinikum Würzburg Germany (DE) Albert-Ludwigs-Universität Freiburg Germany (DE) Karolinska Institute Sweden (SE) University of Turin / Università degli Studi di Torino (UNITO) Italy (IT) University of Ostrava / Ostravská univerzita v Ostravě Czech Republic (CZ) Clinica São Germano Brazil (BR) Jagiellonian University / Uniwersytet Jagielloński (UJ) Poland (PL) Universitätsklinikum Hamburg-Eppendorf (UKE) Germany (DE) Instituto Português de Oncologia Francisco Gentil (IPO) / Portuguese Oncology Institute Portugal (PT) Centre hospitalier universitaire de Poitiers (CHU de Poitiers) France (FR) Columbia University United States (USA) (US) University of Salamanca / Universidad de Salamanca Spain (ES) Università degli Studi di Pavia Italy (IT) University of Paris 4 - Paris-Sorbonne / Université paris IV Paris-Sorbonne France (FR) Hôpital Hôtel-Dieu, APHP France (FR) University of Toronto Canada (CA) Erasmus University Rotterdam (EUR) / Erasmus Universiteit Rotterdam Netherlands (NL) Levine Cancer Institute United States (USA) (US) Vrije Universiteit Brussel (VUB) Belgium (BE) Hackensack Meridian School of Medicine (HMSOM) United States (USA) (US) NTNU Trondheim - Norwegian University of Science and Technology Norway (NO)

How to cite

APA:

Rosinol, L., Beksac, M., Zamagni, E., Van De Donk, N.W.C.J., Anderson, K.C., Badros, A.,... Blade, J. (2021). Expert review on soft-tissue plasmacytomas in multiple myeloma: definition, disease assessment and treatment considerations. British Journal of Haematology, 194(3), 496-507. https://doi.org/10.1111/bjh.17338

MLA:

Rosinol, Laura, et al. "Expert review on soft-tissue plasmacytomas in multiple myeloma: definition, disease assessment and treatment considerations." British Journal of Haematology 194.3 (2021): 496-507.

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