Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 8.177
Filtrar
1.
Curr Oncol ; 29(9): 6236-6244, 2022 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-36135059

RESUMO

(1) Background: Plasma cell neoplasia can be separated into independent subtypes including multiple myeloma (MM) and solitary plasmacytoma of the bone (SBP). The first clinical signs patients present with are skeletal pain, most commonly involving ribs and vertebrae. (2) Methods: Retrospective analysis of 114 patients (38 female, 76 male) receiving spinal surgery from March 2006 until April 2020. Neurological impairments and surgical instability were the criteria for intervention in this cohort. Analysis was based on demographic data, Spinal Instability Neoplastic Score (SINS), location of the lesion, spinal levels of tumor involvement, surgical treatment, histopathological workup, adjuvant therapy, functional outcome, and overall survival (OS). (3) Results: The following surgical procedures were performed: posterior stabilization only in 9 patients, posterior stabilization and decompression without vertebral body replacement in 56 patients, tumor debulking and decompression only in 8 patients, anterior approach in combined approach without vertebral body replacement and without biopsy and/or without kyphoplasty in 33 patients, 3 patients received biopsies only, and 5 patients received kyphoplasty only. The histopathology diagnoses were MM in 94 cases and SBP in 20 cases. Median OS was 72 months (53.4-90.6 months). Preoperative KPSS was 80% (range 40-100%), the postoperative KPSS was 80% (range 50-100%). (4) Conclusions: Surgery for patients with plasma cell neoplasia is beneficial in case of neurological impairment and spinal instability. Moreover, we were able to show that patients with MM and a low number of spinal levels to be supplied have a better prognosis as well as a younger age at the time of the surgical intervention.


Assuntos
Mieloma Múltiplo , Plasmocitoma , Neoplasias da Coluna Vertebral , Feminino , Humanos , Masculino , Mieloma Múltiplo/patologia , Plasmócitos/patologia , Plasmocitoma/patologia , Plasmocitoma/cirurgia , Estudos Retrospectivos , Neoplasias da Coluna Vertebral/patologia , Neoplasias da Coluna Vertebral/cirurgia , Coluna Vertebral/patologia , Coluna Vertebral/cirurgia , Resultado do Tratamento
2.
Blood Cancer J ; 12(9): 135, 2022 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-36114167

RESUMO

From January 1970 to December 2018, 1304 patients were diagnosed with multiple myeloma (MM) at our institution and 256 (19.6%) had plasmacytomas (Ps) (paraskeletal -PPs- 17.6%, extramedullary -EMPs-1.9%). Patients with Ps had lower serum M-protein and less advanced ISS stage than those without. At first relapse, 192 out of 967 patients (19.8%) developed Ps (PPs 14.6%, EMPs 5.1%). The only factor associated with Ps at relapse was the presence of Ps at diagnosis (46% vs 13%, p < 0.00001) with no impact with exposure to novel drugs or previous autologous stem-cell transplantation (ASCT). The median overall survival (OS) was 45, 44 and 20 months for patients without Ps, PPs and EMPs, respectively (p = 0.013). Patients with PPs who underwent ASCT had similar OS than those without Ps (98 vs. 113 months) and significantly longer than those with EMPs (98 vs 47 months, p = 0.006). In patients non-eligible for ASCT the presence of PPs or EMPs was associated with shorter OS compared with patients without Ps (32 vs. 24 vs. 6 months, p = 0.009). In the relapsed setting, a significant survival benefit was observed beyond the year 2000, but still with significant differences among patients without Ps, PPs and EMPs (37 vs 22 vs 16 months, p = 0.003). Importantly, rescue therapy with combinations of proteasome-inhibitors plus immunomodulatory drugs was associated with prolonged OS from first relapse (over 6 years), even in patients with EMPs.


Assuntos
Mieloma Múltiplo , Plasmocitoma , Humanos , Mieloma Múltiplo/diagnóstico , Mieloma Múltiplo/terapia , Recidiva Local de Neoplasia , Plasmocitoma/diagnóstico , Plasmocitoma/terapia , Complexo de Endopeptidases do Proteassoma , Transplante Autólogo
4.
Jt Dis Relat Surg ; 33(2): 449-454, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35852207

RESUMO

OBJECTIVES: The aim of this study was to examine the characterization of tumors and tumor-like lesions located in the clavicle and to present their clinical results. PATIENTS AND METHODS: Between January 2006 and December 2018, a total of 44 patients (25 males, 19 females; mean age: 36.2±21.8 years; range, 2 to 87 years) who were operated in our clinic for a clavicular lesion were included. Among 4,856 extremity tumors operated in our clinic between these years, 44 cases (0.9%) located in the clavicle were eligible. Demographic data, tumor types, location, surgical method, metastasis, survival analyzes and clinical results of these patients were reviewed retrospectively. According to the clavicle location, the patients were divided into groups according to their involvement in proximal, middle, lateral and more than one region. RESULTS: The most frequently involved site was the lateral edge of the clavicle, and the most common tumor was aneurysmal bone cyst. The most common malignant tumor was Ewing sarcoma and plasmacytoma (13.6%) and the most common surgical method in the clavicle was wide resection with 34.1%. Of the 38 primary clavicle tumors remaining after the metastatic lesions were removed, 21 (55%) were benign, while 17 (45%) were malignant. Aneurysmal bone cyst was most common in the group under 30 years of age, osteochondroma was most common in the 30-50 age group, and plasmacytoma was most common in those over 50 years of age. The mean musculoskeletal tumor society (MSTS) score of 15 patients (34.1%) who underwent clavicle resection was 79.4±6. CONCLUSION: We believe that a wide spectrum should be considered in the differential diagnosis of tumors located in the clavicle. Age is an important predictive factor for malignancy. We believe that resection should be applied without fear considering its effects on function and recurrence.


Assuntos
Cistos Ósseos Aneurismáticos , Neoplasias Ósseas , Plasmocitoma , Adolescente , Adulto , Cistos Ósseos Aneurismáticos/patologia , Neoplasias Ósseas/patologia , Clavícula/patologia , Clavícula/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Plasmocitoma/patologia , Estudos Retrospectivos , Adulto Jovem
5.
Artigo em Chinês | MEDLINE | ID: mdl-35822386

RESUMO

This paper reported a case of extramedullary plasmacytoma of the larynx. The patient presented with persistent hoarseness and foreign body sensation in pharynx for 5 months. Left anterior laryngeal mass, left epiglottis fold distention was found during laryngoscopy. Cervical image examination showed that the left side wall of the glottis was thickened and showed a lump-like change, part of which protrusion into the laryngeal cavity, the laryngeal chamber became narrow, and the growth of thyroid cartilage was broken outwards and reached the level of the hyoid bone. After completing the examination, the laryngeal tumor resection and biopsy were performed under the suspension laryngoscope. Pathologic findings showed that diffuse proliferation of small cells was observed in laryngeal subepithelial fibrous tissue, with local appearance of private, atypia and mitosis. Combined with immunohistochemical results, it was consistent with plasma cell tumor.


Assuntos
Neoplasias Laríngeas , Laringe , Plasmocitoma , Epiglote/patologia , Humanos , Neoplasias Laríngeas/cirurgia , Laringoscopia , Laringe/patologia , Plasmocitoma/diagnóstico , Plasmocitoma/patologia , Plasmocitoma/cirurgia
6.
J Investig Med High Impact Case Rep ; 10: 23247096221111773, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35850540

RESUMO

Breast plasmacytoma is relatively uncommon in which most of the recorded cases were related to disseminated multiple myeloma. However, many of these cases tend to be misdiagnosed with other breast lesions such as breast carcinoma. This article presents a case study on a Libyan female patient around the age of 55 who has a single breast lump, which was first diagnosed to be a malignant lesion. All the results of immunostaining for cytokeratins, GATA3, estrogen receptor, progesterone receptor, HER2, and E-cadherin were negative; hence, the possibility of a breast carcinoma was not considered. However, plasma cell tumors were indicated by the presence of CD138, MUM1, and kappa-light chain markers. In addition, the patient had multiple osteolytic bone lesions, plasma cell infiltration, a monoclonal gammopathy, and signs of renal failure, which considered to be an indication to an extra-medullary breast plasmacytoma secondary to advanced multiple myeloma. This case study emphasizes the necessity of complete histopathological and imaging evolution for proper diagnosis of breast plasmacytoma.


Assuntos
Gamopatia Monoclonal de Significância Indeterminada , Mieloma Múltiplo , Plasmocitoma , Feminino , Humanos , Gamopatia Monoclonal de Significância Indeterminada/patologia , Mieloma Múltiplo/complicações , Mieloma Múltiplo/diagnóstico , Plasmocitoma/diagnóstico por imagem , Plasmocitoma/patologia , Tomografia Computadorizada por Raios X
7.
BMJ Case Rep ; 15(7)2022 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-35868805

RESUMO

A man in his 70s with a history of multiple myeloma presented with a 4-day history of right ptosis and a rapidly enlarging upper eyelid mass. On examination, a large, firm, smooth, pink lesion was found to descend from the conjunctiva of the superior fornix. The patient underwent excision biopsy. Histopathological analysis demonstrated monoclonal plasma cells expressing light-chain kappa, consistent with extramedullary plasmacytoma. Clinical ophthalmic manifestations of multiple myeloma are rare but also diverse. Ocular surface manifestations of multiple myeloma are extremely uncommon. Variable examination findings mean those involving the conjunctiva and may be particularly challenging to diagnose. Secondary ocular extramedullary plasmacytoma, despite its rarity, should be considered in patients with multiple myeloma.


Assuntos
Blefaroptose , Mieloma Múltiplo , Plasmocitoma , Biópsia , Blefaroptose/etiologia , Túnica Conjuntiva/patologia , Humanos , Masculino , Mieloma Múltiplo/complicações , Mieloma Múltiplo/diagnóstico , Mieloma Múltiplo/patologia , Plasmocitoma/complicações , Plasmocitoma/diagnóstico , Plasmocitoma/patologia
8.
Hinyokika Kiyo ; 68(5): 149-153, 2022 May.
Artigo em Japonês | MEDLINE | ID: mdl-35748233

RESUMO

A 78-year-old man was treated with Bortezomib, Lenalidomide, and Dexamethasone, for multiple myeloma. Two years after the start of treatment, the patient came to our department with a complaint of gross hematuria. Cystoscopy revealed a tumor on the left wall of the bladder. Urine cytology was negative. Magnetic resonance imaging (MRI) of the lower abdomen showed a slightly high signal on the T2-weighted image, indicating an intravesical mass lesion invading outside the bladder. Contrast-enhanced computed tomography (CT) also showed an intravesical mass and enlarged left external iliac lymph node swelling. Transurethral resection of bladder tumor was performed. The resection specimen showed tumor cells. The pathological examination revealed CD138 (+) and light-chain restriction. The patient was diagnosed with plasmacytoma. The patient was treated with radiation therapy for plasmacytoma of the bladder and surrounding lymph nodes, and then with daratumumab and dexamethasone for multiple myeloma for one year; however, the patient died because of worsening of multiple myeloma.


Assuntos
Mieloma Múltiplo , Plasmocitoma , Neoplasias da Bexiga Urinária , Idoso , Dexametasona/uso terapêutico , Humanos , Masculino , Mieloma Múltiplo/diagnóstico , Mieloma Múltiplo/terapia , Plasmocitoma/diagnóstico por imagem , Plasmocitoma/terapia , Bexiga Urinária , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/terapia
9.
Bioengineered ; 13(5): 13680-13688, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35706414

RESUMO

Long non-coding RNA (lncRNA) plasmacytoma variant translocation 1 (PVT1) and growth arrest specific 5 (GAS5) have opposite functions in the apoptosis of chondrocytes, which are involved in the pathogenesis of osteoarthritis (OA). The opposite roles of PVT1 and GAS5 in OA may indicate the existence of crosstalk between them in OA. This study aimed to explore the possible interaction between PVT1 and GAS5 in OA. Accumulation of PVT1 and GAS5 in OA and control synovial fluid samples was measured by RT-qPCR. The interaction between PVT1 and GAS5 in chondrocytes was explored by overexpression experiments. Dual-luciferase reporter assay was performed to analyze the binding of PVT1 and GAS5 to each other's promoter regions. Regulatory roles of PVT1 and GAS5 in the apoptosis of chondrocytes were studied with cell apoptosis assay. PVT1 was upregulated in OA, and GAS5 was downregulated in OA. An inverse correlation between PVT1 and GAS5 was observed across OA samples. Under lipopolysaccharides (LPS) treatment, PVT1 was upregulated and GAS5 was downregulated. Interestingly, PVT1 and GAS5 overexpression downregulated each other in chondrocytes. Cell apoptosis analysis showed that PVT1 overexpression promoted cell apoptosis, while GAS5 overexpression suppressed cell apoptosis induced by LPS. Co-transfection of PVT1 and GAS5 failed to significantly affect cell apoptosis. PVT1 and GAS5 directly bound to each other's promoter regions. Our study characterized the interaction between PVT1 and GAS5 in OA. Their interaction regulated the apoptosis of chondrocytes, which play a critical role in OA. PVT1 and GAS5 may form a negative feedback loop in OA.


Assuntos
MicroRNAs , Osteoartrite , Plasmocitoma , RNA Longo não Codificante , Apoptose/genética , Condrócitos/metabolismo , Humanos , Lipopolissacarídeos/metabolismo , MicroRNAs/metabolismo , Osteoartrite/genética , Osteoartrite/metabolismo , Plasmocitoma/complicações , Plasmocitoma/metabolismo , Plasmocitoma/patologia , RNA Longo não Codificante/genética , RNA Longo não Codificante/metabolismo
10.
Biomed Res Int ; 2022: 7387416, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35692586

RESUMO

Background: Solitary plasmacytoma of bone (SPB) is an isolated plasmacytoma of bone origin, most commonly seen in the elderly, with a poor prognosis. So far, there is no precise nomogram to predict the overall survival (OS) of elderly patients with SPB. Our goal is to construct and validate a nomogram for elderly patients with SPB. Methods: This study collected all elderly patients with SPB in the Surveillance, Epidemiology and End Results (SEER) database from 2000 to 2018, and the variables included were age, sex, race, marital status, primary site, grade, stage, surgery, chemotherapy, and radiotherapy. Independent prognostic factors were identified using univariate and multivariate Cox analysis. The nomogram was constructed to predict 1-, 2-, and 3-year OS of elderly patients with SPB. The receiver-operating characteristic (ROC) and the calibration curves were used to differentiate and calibrate the nomogram. The clinical validity of the nomogram was evaluated by decision curve analysis (DCA). The total OS scores of all elderly SPB patients were calculated and divided into two risk subgroups for comparison. Results: A total of 1837 patients diagnosed with SPB were screened from the SEER database, with a final inclusion of 1180 patients (age ≥ 60 years). Age, radiotherapy, and marital status were significantly correlated with OS. These characteristics were further incorporated into the creation of the nomogram for predicting 1-, 2-, and 3-year OS of elderly patients with SPB. For this predictive model, the area under the ROC curves, calibration curves, and DCA have good performance in terms of differentiation, consistency, and validity, respectively. In addition, patients in the high-risk group (≥96) had a worse prognosis than those in the low-risk group (<96). Conclusion: We constructed a nomogram and a risk classification system that could provide an intuitive and effective tool for clinicians to better predict the OS of elderly SPB patients.


Assuntos
Neoplasias Ósseas , Plasmocitoma , Idoso , Humanos , Pessoa de Meia-Idade , Nomogramas , Prognóstico , Modelos de Riscos Proporcionais , Programa de SEER
11.
Transplant Proc ; 54(5): 1380-1383, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35760627

RESUMO

Liver transplantation is the only potentially curative treatment for patients with end-stage liver disease. After the procedure, histopathologic analysis of the liver explant may reveal neoplasms that were not previously diagnosed in preoperative imaging examinations. This incidental finding of primary liver neoplasms in the explant is not an uncommon situation in liver transplant, and hepatocarcinomas and cholangiocarcinomas are the types of tumors most frequently encountered in this scenario. These are the most common primary neoplasms of the liver, and liver transplantation is often a curative treatment for these types of tumors when they are in their earlier stages. In contrast, liver plasmacytoma is a rare type of plasma cell neoplasm, consisting of a single mass of monoclonal plasma cells, which is treated primarily by radiotherapy and is seldom encountered in the setting of liver transplant. We report the case of a patient who underwent liver transplantation for the treatment of cryptogenic cirrhosis, with no preoperative diagnosis of liver tumors. Analysis of the liver explant revealed the presence of three synchronous neoplasms with different histologic origins: a 27-mm hepatocellular carcinoma, a 17-mm intrahepatic cholangiocarcinoma, and a 25-mm solitary hepatic plasmacytoma. The patient received no further adjuvant treatment and remained well and with no signs of disease recurrence over an observation period of 44 months. We found no previous report in the literature of the synchronous presence of these three types of liver neoplasms.


Assuntos
Neoplasias dos Ductos Biliares , Carcinoma Hepatocelular , Colangiocarcinoma , Neoplasias Hepáticas , Neoplasias Primárias Múltiplas , Plasmocitoma , Neoplasias dos Ductos Biliares/cirurgia , Ductos Biliares Intra-Hepáticos/patologia , Carcinoma Hepatocelular/cirurgia , Colangiocarcinoma/patologia , Humanos , Achados Incidentais , Neoplasias Hepáticas/patologia , Recidiva Local de Neoplasia , Neoplasias Primárias Múltiplas/cirurgia
12.
Am J Surg Pathol ; 46(10): 1364-1379, 2022 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-35650679

RESUMO

Epstein-Barr virus (EBV)-positive plasmacytoma is a rare plasma cell neoplasm. It remains unclear whether EBV-positive plasmacytoma represents a distinct entity or a variant of plasmacytoma. It shares morphologic features with plasmablastic lymphoma (PBL) and may cause diagnostic uncertainty. To better understand EBV-positive plasmacytoma and explore diagnostic criteria, this study describes 19 cases of EBV-positive plasmacytoma, compared with 27 cases of EBV-negative plasmacytoma and 48 cases of EBV-positive PBL. We reviewed the clinicopathologic findings and performed immunohistochemistry, in situ hybridization for EBV, fluorescence in situ hybridization for MYC , and next-generation sequencing. We found that 63.2% of patients with EBV-positive plasmacytoma were immunocompromised. Anaplastic features were observed in 7/19 cases. MYC rearrangement was found in 25.0% of them, and extra copies of MYC in 81.3%. EBV-positive and EBV-negative plasmacytomas possessed similar clinicopathologic features, except more frequent cytologic atypia, bone involvement and MYC aberrations in the former group. The survival rate of patients with EBV-positive plasmacytoma was comparable to that of patients with EBV-negative plasmacytoma. In comparison to PBL, EBV-positive plasmacytoma is less commonly associated with a "starry-sky" appearance, necrosis, absence of light chain expression, and a high Ki67 index (>75%). The most recurrently mutated genes/signaling pathways in EBV-positive plasmacytoma are epigenetic regulators, MAPK pathway, and DNA damage response, while the most frequently reported mutations in PBL are not observed. Collectively, EBV-positive plasmacytoma should be regarded as a biological variant of plasmacytoma. Thorough morphologic examination remains the cornerstone for distinguishing EBV-positive plasmacytoma and PBL, and molecular studies can be a valuable complementary tool.


Assuntos
Infecções por Vírus Epstein-Barr , Plasmocitoma , Infecções por Vírus Epstein-Barr/complicações , Infecções por Vírus Epstein-Barr/diagnóstico , Herpesvirus Humano 4/genética , Humanos , Hibridização in Situ Fluorescente , Antígeno Ki-67 , Plasmocitoma/complicações , Plasmocitoma/diagnóstico , Plasmocitoma/genética
14.
Int J Mol Sci ; 23(9)2022 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-35563626

RESUMO

Vascular endothelial growth factor (VEGF) has important effects on hematopoietic and immune cells. A link between VEGF expression, tumor progression, and metastasis has been established in various solid tumors; however, the impact of VEGF expression by hematopoietic neoplasias remains unclear. Here, we investigated the role of VEGF in plasma cell neoplasia. Overexpression of VEGF in MOPC 315 tumor cells (MOPCSVm) had no effect on their growth in vitro. However, constitutive ectopic expression of VEGF dramatically reduced tumorigenicity of MOPC 315 when implanted subcutaneously into BALB/c mice. Mice implanted with MOPCSVm effectively rejected tumor grafts and showed strong cytotoxic T lymphocyte (CTL) activity against parental MOPC 315 cells. MOPCSVm implants were not rejected in nude mice, suggesting the process is T-cell-dependent. Adoptive transfer of splenocytes from recipients inoculated with MOPCSVm cells conferred immunity to naïve BALB/c mice, and mice surviving inoculation with MOPCSVm rejected the parental MOPC 315 tumor cells following a second inoculation. Immunohistochemical analysis showed that MOPCSVm induced a massive infiltration of CD3+ cells and MHC class II+ cells in vivo. In addition, exogenous VEGF induced the expression of CCR3 in T cells in vitro. Together, these data are the first to demonstrate that overexpression of VEGF in plasmacytoma inhibits tumor growth and enhances T-cell-mediated antitumor immune response.


Assuntos
Plasmocitoma , Fator A de Crescimento do Endotélio Vascular/metabolismo , Animais , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , Plasmocitoma/genética , Plasmocitoma/patologia , Linfócitos T Citotóxicos , Fator A de Crescimento do Endotélio Vascular/genética
15.
Clin Lymphoma Myeloma Leuk ; 22(8): 635-642, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35610120

RESUMO

INTRODUCTION: Daratumumab is an anti-CD38 agent that was first investigated as single agent in GEN501 and SIRIUS trials in patients with advanced multiple myeloma (MM). Overall response rate (ORR) was 30% with positive impact on progression-free survival (PFS). However, there is a lack of information regarding plasmacytoma response. MATERIALS AND METHODS: Here, we described a heavily pretreated group of 43 patients who received daratumumab monotherapy after EMA approval and focused on plasmacytoma response. RESULTS: After a median follow-up of 26 months, median time to best response was 2.9 months (range 0.8-13.1), median PFS was 5.2 months (95% CI 2.5 - 8.8) and median OS was 11.2 months (95% CI 6.3 - 17.0). Patients who achieved at least partial response had longer median PFS and OS (12.8 and 20.2 months, respectively) than those who achieved minimal response or stable disease (5.3 and 11.2 months, respectively). Ten patients (23%) had plasmacytomas (70% paraskeletal, 30% extramedullary). The clinical benefit for patients with and without plasmacytomas was 20% versus 42%. A dissociation between serological and plasmacytoma response was observed in 40% of the patients. Thus, 50% of the patients with plasmacytomas achieved at least serological minimal response but only 20% had plasmacytoma response. CONCLUSION: This is the first real-world study of daratumumab monotherapy that focuses on efficacy data regarding soft-tissue plasmacytomas in patients with relapsed/refractory mieloma, showing a limited benefit in this patient population.


Assuntos
Mieloma Múltiplo , Plasmocitoma , Anticorpos Monoclonais/farmacologia , Anticorpos Monoclonais/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Resistencia a Medicamentos Antineoplásicos , Humanos , Mieloma Múltiplo/tratamento farmacológico , Plasmocitoma/tratamento farmacológico
16.
Ann Hematol ; 101(6): 1217-1226, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35445844

RESUMO

Plasmacytoma has been reported to be associated with a poor prognosis in patients with multiple myeloma (MM). In this study, we evaluated the incidence of relapse with plasmacytoma and survival outcomes after upfront autologous stem cell transplantation (ASCT). This study retrospectively analyzed the data of 303 patients with MM who underwent upfront ASCT between April 2000 and April 2018 at eight institutes in the Republic of Korea. In total, 52 patients (17.1%) had plasmacytoma at MM relapse after upfront ASCT, of whom, 27 had paramedullary plasmacytoma (PMD) and 25 had extramedullary plasmacytoma (EMD). Patients with initial plasmacytoma were more likely to have plasmacytoma at MM relapse than those without initial plasmacytoma (37.1% vs. 11.2%). Over a median follow-up of 66.0 months, patients with plasmacytoma at relapse had significantly inferior overall survival (OS) than those without plasmacytoma (43.9 vs. 100.7 months, P < 0.001), but the OS did not significantly differ between patients with EMD and those with PMD (42.2 vs. 56.6 months, P = 0.464). After MM relapse, all patients received salvage therapy, and progression-free survival after relapse was significantly shorter in patients with plasmacytoma than in those without (6.4 vs. 12.4 months, P = 0.007). This study showed that plasmacytoma frequently developed at MM relapse after upfront ASCT in patients with plasmacytoma at the time of diagnosis. Plasmacytoma at relapse was significantly associated with a poor prognosis.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Mieloma Múltiplo , Plasmocitoma , Humanos , Recidiva Local de Neoplasia/terapia , Plasmocitoma/terapia , Estudos Retrospectivos , Transplante de Células-Tronco , Transplante Autólogo
17.
Expert Rev Hematol ; 15(4): 369-374, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35387532

RESUMO

BACKGROUND: Extramedullary myeloma has a more aggressive clinical course and inferior prognosis. Two types of extramedullary myeloma, paraosseous (PO) and extraosseous (EO), differ significantly in pathogenesis, clinical features, and outcomes, but there have been limited studies comparing them based on large patient cohorts. METHODS: Relevant studies published before June 2021 were searched in MEDLINE, Embase, and Cochrane databases. Two reviewers independently assessed the quality of included studies, and discrepancies were evaluated by a third reviewer. Extracted data were analyzed by Stata 12. RESULTS: Nine hundred ninety-seven MM patients with PO and 288 with EO plasmacytoma were analyzed. Patients with EO plasmacytoma tended to have larger tumor burden according to the International Staging System though it did not reach statistical significance (P = 0.1). Newly diagnosed MM (NDMM) patients with EO plasmacytoma had significantly inferior outcome than those with PO plasmacytoma (OS: OR = 2.32, 95% CI 1.80-2.98, P < 0.001, I2 = 40.9%; PFS: OR = 1.66, 95% CI 1.39-1.99, P < 0.001, I2 = 0.0%). No significant difference in OS was found in relapsed MM patients. Auto-HSCT seemed to attenuate the disadvantage in response rate of EO plasmacytoma. CONCLUSIONS: NDMM patients with EO plasmacytoma had significantly inferior prognosis than those with PO plasmacytoma, while relapsed MM patients did not show such difference. More strategies are needed to improve its clinical outcome.


Assuntos
Mieloma Múltiplo , Plasmocitoma , Humanos , Imunoterapia/efeitos adversos , Mieloma Múltiplo/complicações , Mieloma Múltiplo/diagnóstico , Mieloma Múltiplo/tratamento farmacológico , Plasmocitoma/complicações , Plasmocitoma/diagnóstico , Plasmocitoma/tratamento farmacológico , Prognóstico
18.
Clin Nucl Med ; 47(8): e565-e567, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35439181

RESUMO

ABSTRACT: Hemorrhagic pseudotumor occurs in approximately 1% to 2% of patients with hemophilia. This lesion is exceptionally rare in nonhemophiliac individuals. The authors present a case of treated right ischial plasmacytoma with a progressively enlarging expansile hemorrhagic pseudotumor, documented on 18 F-FDG PET/CT and MRI and confirmed by histology.


Assuntos
Plasmocitoma , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Fluordesoxiglucose F18 , Humanos , Plasmocitoma/diagnóstico por imagem , Plasmocitoma/patologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos
19.
Am J Rhinol Allergy ; 36(5): 591-598, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35440217

RESUMO

BACKGROUND: While extramedullary plasmacytomas are infrequently encountered plasma cell malignancies, most cases occur in the head and neck, with a predilection for the sinonasal cavity. Due to the rarity of this disease, the majority of studies on sinonasal extramedullary plasmacytoma (SN-EMP) are case reports or small retrospective case series. OBJECTIVE: To investigate the impact of patient, disease, and treatment factors on the survival of patients with SN-EMP. METHODS: The National Cancer Database was queried for all patients with SN-EMP between 2004-2016 (N = 381 cases). Univariate and multivariate analyses were used to examine patient demographics, tumor characteristics, and survival. RESULTS: The majority of SN-EMP patients were over 60 years old (57.0%), male (69.8%), and white (86.2%). The most common treatment modality was radiotherapy alone (38.6%), followed by surgery plus radiotherapy (37.8%). Five-year overall survival was 74.0% and median survival was 9.1 years. Accounting for patient demographics and tumor characteristics in a multivariate model, the following groups had worse prognosis: 60 and older (HR 1.99, p = 0.031) and frontal sinus primary site (HR 11.56, p = 0.001). Patients who received no treatment (HR 3.89, p = 0.013), chemotherapy alone (HR 5.57, p = 0.008) or radiotherapy plus chemotherapy (HR 2.82, p = 0.005) had significantly lower survival than patients who received radiotherapy alone. Patients who received surgery with radiotherapy (HR 0.57, p = 0.039) had significantly higher survival than patients who received radiotherapy alone. CONCLUSION: In patients with SN-EMP five-year overall survival was found to be 74.0% with decreased survival associated with a frontal sinus primary site and being aged 60 or older. Patients receiving no treatment, chemotherapy alone, or radiotherapy with chemotherapy was associated with lower survival. Receiving surgery plus radiotherapy was associated with the highest five-year overall survival.


Assuntos
Neoplasias dos Seios Paranasais , Plasmocitoma , Terapia Combinada , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias dos Seios Paranasais/terapia , Plasmócitos , Plasmocitoma/patologia , Plasmocitoma/cirurgia , Estudos Retrospectivos , Análise de Sobrevida
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...