Delauche-Cavallier M C, Laredo J D, Wybier M, Bard M, Mazabraud A, Le Bail Darne J L, Kuntz D, Ryckewaert A
Service de Rhumatologie, Hôpital Lariboisière, Paris.
Cancer. 1988 Apr 15;61(8):1707-14. doi: 10.1002/1097-0142(19880415)61:8<1707::aid-cncr2820610832>3.0.co;2-n.
The data for 19 patients with solitary plasmacytoma of the spine were reviewed with regard to clinical course and prognosis (median follow-up, 96 months). Eight patients presented with spinal cord compression. A monoclonal immunoglobulin was initially detected in seven of 15 evaluable patients. Treatment included radiotherapy (18 of 19) and/or surgery (11 of 19) and chemotherapy (eight of 19). Spinal cord compression was reversed in every patient. The expected survival rate was 85% at 10 years after diagnosis. Local recurrence or dissemination was observed in 13 patients. It occurred within 5 years of diagnosis in 11 patients and was localized (that is, local recurrence or single bone metastasis) in eight patients. It was always associated with the appearance or an increase of the M component. Dissemination frequently had a "metastatic" pattern with no diffuse bone marrow plasmacytosis. The incidence of local recurrence (five patients) and leukemia (four patients) was high. Local recurrence and/or dissemination were significantly more frequent in patients with the M component at diagnosis than in those without it (P less than 0.05; relative risk, R = 4). The effectiveness of surgery and chemotherapy combined with radiotherapy is also discussed.
回顾了19例脊柱孤立性浆细胞瘤患者的临床病程及预后数据（中位随访时间96个月）。8例患者出现脊髓压迫。15例可评估患者中有7例最初检测到单克隆免疫球蛋白。治疗包括放疗（19例中的18例）和/或手术（19例中的11例）以及化疗（19例中的8例）。每位患者的脊髓压迫均得到缓解。诊断后10年的预期生存率为85%。13例患者出现局部复发或播散。11例患者在诊断后5年内发生，8例为局限性（即局部复发或单骨转移）。其总是与M成分的出现或增加相关。播散通常呈“转移”模式，无弥漫性骨髓浆细胞增多。局部复发（5例患者）和白血病（4例患者）的发生率较高。诊断时伴有M成分的患者局部复发和/或播散明显比无M成分的患者更频繁（P<0.05；相对危险度，R=4）。还讨论了手术及化疗联合放疗的疗效。
