Charalampous Charalampos, Claveau Jean-Sebastien, Kapoor Prashant, Binder Moritz, Buadi Francis K, Cook Joselle, Dingli David, Dispenzieri Angela, Fonder Amie L, Gertz Morie A, Gonsalves Wilson, Hayman Suzanne R, Hobbs Miriam A, Hwa Yi L, Kourelis Taxiarchis, Lacy Martha Q, Leung Nelson, Lin Yi, Warsame Rahma, Kyle Robert A, Rajkumar S Vincent, Kumar Shaji K
Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
Blood Adv. 2025 Apr 8;9(7):1559-1570. doi: 10.1182/bloodadvances.2024013355.
In this study, we first analyzed data from 147 patients with solitary plasmacytomas treated at the Mayo Clinic between 2005 and 2022 and then expanded our investigation through a systematic review and meta-analysis of 62 studies, encompassing 3487 patients from the years 1960 to 2022. Our findings reveal that patients with up to 10% clonal plasma cells in their bone marrow (BM), denoted as plasmacytoma +, had a significantly reduced median disease-free survival (DFS) of 15.7 months vs 79 months, P < .05, observed in patients with true solitary plasmacytomas, with no clonal cells in the BM. Risk factors identified for shorter DFS included the presence of clonal plasma cells in the marrow and a difference between involved and uninvolved free light chains of >5 mg/dL. The meta-analysis portion of our study highlighted a male predominance among patients, with a median age of 58 years, and confirmed radiation therapy as the predominant treatment modality. We also found that DFS rates at 3, 5, and 10 years were 66.9%, 55%, and 42.1%, respectively, and noted a significant difference in outcomes between patients with bone and extramedullary plasmacytomas, with the latter group exhibiting better survival rates. This dual-faceted approach provides a thorough overview of survival rates and critical risk factors for patients with plasmacytoma, underscoring the vital role of accurate disease staging at diagnosis and the impact of tumor location on patient prognosis.
在本研究中，我们首先分析了2005年至2022年在梅奥诊所接受治疗的147例孤立性浆细胞瘤患者的数据，然后通过对62项研究进行系统综述和荟萃分析来扩展我们的调查，这些研究涵盖了1960年至2022年的3487例患者。我们的研究结果显示，骨髓（BM）中克隆性浆细胞比例高达10%的患者（称为浆细胞瘤+）的无病生存期（DFS）中位数显著缩短，为15.7个月，而真正的孤立性浆细胞瘤患者（BM中无克隆细胞）的DFS中位数为79个月，P <.05。确定的DFS较短的风险因素包括骨髓中存在克隆性浆细胞以及受累和未受累游离轻链之间的差异>5 mg/dL。我们研究的荟萃分析部分强调了患者以男性为主，中位年龄为58岁，并证实放射治疗是主要的治疗方式。我们还发现，3年、5年和10年的DFS率分别为66.9%、55%和42.1%，并注意到骨浆细胞瘤和髓外浆细胞瘤患者的结局存在显著差异，后者的生存率更高。这种双方面的方法全面概述了浆细胞瘤患者的生存率和关键风险因素，强调了诊断时准确疾病分期的重要作用以及肿瘤位置对患者预后的影响。
