Details

Autor(en) / Beteiligte

• FOUQUET, Guillemette
• GUIDEZ, Stéphanie
• BERTHON, Céline
• TERRIOU, Louis
• COITEUX, Valérie
• MACRO, Margaret
• DECAUX, Olivier
• FACON, Thierry
• HUGLO, Damien
• LELEU, Xavier
• HERBAUX, Charles
• VAN DE WYNGAERT, Zoé
• BONNET, Sarah
• BEAUVAIS, David
• DEMARQUETTE, Hélène
• ADIB, Salim
• HIVERT, Bénédicte
• WEMEAU, Mathieu

Titel

Impact of Initial FDG-PET/CT and Serum-Free Light Chain on Transformation of Conventionally Defined Solitary Plasmacytoma to Multiple Myeloma

Ist Teil von

• Clinical cancer research, 2014-06, Vol.20 (12), p.3254-3260

Ort / Verlag

Philadelphia, PA: American Association for Cancer Research

Erscheinungsjahr

2014

Quelle

MEDLINE

Beschreibungen/Notizen

• 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. 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. 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. 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. .