[Apparently isolated plasmacytoma of bone. Clinical and prognostic data. 114 cases and review of literature (author's transl)].

The authors review 114 cases (including 18 personal cases) of apparently isolated plasmacytoma of bone (AIPB) followed-up for periods of a few weeks to 24 years. The number of patients still alive, without recurrence and/or extension to the bone marrow sharply dropped from 77% after 2 years to 15% after 10 years. At the time of diagnosis, AIPB with secondary medullary involvement differed from conventional multiple myeloma of bone on six points: mean age 52,1 versus 63,2 years (p less than 0,001); male prevalence 60,5% vs 38,5% (p less than 0,02); spinal involvement 61,8% vs 88,7% (p less than 0,05); radiological aspect of giant cell tumour 33,3% vs 3% (p less than 0,001); cord involvement 25% vs 5,4% (p less than 0,001); lack of monoclonal component 82,5% vs 4,3% (p less than 0,001). On the other hand, after 10 years there were only three differences between AIPB with and without secondary extension to the bone marrow: mean age 52,1 vs 45,7 years (p less than 0,1); spinal involvement 61,8% vs 26,7% (p less than 0,01); loss of monoclonal component after local treatment 29% vs 100% (p less than 0,05). These data suggest that isolated (i.e. localized) and multiple (i.e. disseminated) myelomas are distinct manifestations of bone marrow malignant plasma cell dyscrasias and that the patient's age, the site of the tumour and the disappearance of the monoclonal component are relevant to the prognosis of the disease.