BioMedical Sciences Graduate Program, Chonnam National University, Gwangju, Republic of Korea.
Department of Hematology-Oncology, Chonnam National University Hwasun Hospital and Chonnam National University Medical School, 322 Seoyangro, Hwasun, Jeollanamdo, Seoul, 58128, Republic of Korea.
Ann Hematol. 2022 Jun;101(6):1217-1226. doi: 10.1007/s00277-022-04776-0. Epub 2022 Apr 21.
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.
浆细胞瘤已被报道与多发性骨髓瘤（MM）患者的预后不良相关。在这项研究中，我们评估了 upfront 自体干细胞移植（ASCT）后浆细胞瘤复发的发生率和生存结局。本研究回顾性分析了 2000 年 4 月至 2018 年 4 月在韩国 8 个研究所接受 upfront ASCT 的 303 例 MM 患者的数据。共有 52 例（17.1%）在 upfront ASCT 后 MM 复发时出现浆细胞瘤，其中 27 例为髓旁浆细胞瘤（PMD），25 例为髓外浆细胞瘤（EMD）。初诊时即有浆细胞瘤的患者比没有初诊浆细胞瘤的患者更有可能在 MM 复发时出现浆细胞瘤（37.1% vs. 11.2%）。在中位随访 66.0 个月期间，复发时有浆细胞瘤的患者总生存（OS）明显低于无浆细胞瘤的患者（43.9 个月 vs. 100.7 个月，P < 0.001），但 EMD 与 PMD 患者的 OS 无显著差异（42.2 个月 vs. 56.6 个月，P = 0.464）。在 MM 复发后，所有患者均接受挽救治疗，复发后无进展生存时间在有浆细胞瘤的患者中明显短于无浆细胞瘤的患者（6.4 个月 vs. 12.4 个月，P = 0.007）。本研究表明，在 upfront ASCT 后，初诊时即有浆细胞瘤的患者 MM 复发时常出现浆细胞瘤。复发时的浆细胞瘤与预后不良显著相关。
