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Solitary Bone Plasmacytoma

Multiple Myeloma Stages
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Solitary Bone Plasmacytoma (also called single plasmacytoma of bone) is a diagnosis of pre-myeloma in which monoclonal proteins have caused only a single plasmacytoma or lesion in the patient’s bone.

A diagnosis of SBP can be further broken down into three categories:

  • solitary bone plasmacytoma
  • Extramedullary SBP
  • SBP of the extremedies

The studies linked and excerpted below mirror my personal experience. I was diagnosed with an SBP in my fifth cervical vertebra in early 1994. I underwent surgery to stabilize my neck followed by local radiation to “clean-up” any monoclonal proteins not removed by the surgery.

I progressed to full multiple myeloma about a year later and then underwent the FDA approved, standard-of-care therapy plan of

  • induction therapy followed by
  • autologous stem cell transplant. 

The point of this post is to illustrate the many issues researched and written about in the blog posts linked below.

Have you been diagnosed with a SPB? Scroll down the page to ask a question and I will reply to you ASAP.

Thank you.

David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Survival trends and prognostic factors in patients with solitary plasmacytoma of bone: A population-based study

“Solitary plasmacytoma is relatively rare, accounting for only 3% of all plasma cell neoplasms. Based on the site of lesion, solitary plasmacytoma is classified into solitary plasmacytoma of bone (SPB) and solitary extramedullary plasmacytoma (SEP).1 SPB is a single, isolated plasmacytoma originated from the bone,2, 3 while solitary extramedullary plasmacytoma is characterized by the presence of plasma cells infiltrating in soft tissue mass.4, 5

The most frequently affected bone is the vertebrae, which is followed by ribs, skull, and pelvic bones. The standard therapy for SPB is radiotherapy, even in patients in whom the tumor is completely resected. Despite the high local control rate with radiotherapy, the rate of recurrence of SPB is high, with approximately two-thirds of cases eventually progress to PCM or additional solitary or multiple plasmacytomas…

Diagnosis and management of solitary extramedullary plasmacytoma

“Plasma cell neoplasms (plasma cell dyscrasias) are a group of entities characterized by the neoplastic proliferation of a single clone of plasma cells, typically producing a monoclonal immunoglobulin. Plasma cell neoplasms can present as a single lesion (solitary plasmacytoma) or as multiple lesions (multiple myeloma).

Solitary plasmacytomas most frequently occur in bone (plasmacytoma of bone), but can also be found outside bone in soft tissues (extramedullary plasmacytoma) [1-4]. Why some patients develop multiple myeloma and others a single plasmacytoma is not understood, but it might be related to differences in cellular adhesion molecules or chemokine receptor expression profiles of the malignant plasma cells [5].

Solitary extramedullary plasmacytomas (SEP; solitary extraosseous plasmacytoma) are plasma cell tumors that arise outside of the bone marrow. They are solitary lesions, and are most often located in the head and neck region, mainly in the upper aerodigestive tract, but may also occur in the gastrointestinal tract, urinary bladder, central nervous system, thyroid, breast, testes, parotid gland, lymph nodes, and skin.

SEP refers to a solitary non-osseus plasma cell neoplasm in the absence of any other sign of multiple myeloma.

Note that extramedullary plasmacytomas can arise in patients with multiple myeloma at any time during the course of the disease, and should not be confused with SEP…”

Prognosis of solitary bone plasmacytoma of the extremities

“Due to the rarity of solitary bone plasmacytoma (SBP), few studies reported the prognosis and survival predictors of SBP, especially for patients with extremity SBP.

A total of 552 patients with extremity SBP were identified from the Surveillance Epidemiology and Ends Results (SEER) database between 1973 and 2016…

This is the first study to identify prognostic factors of extremity SBP by using the SEER database. Our findings highlight that radiotherapy is the mainstream treatment for extremity SBP. Additionally, age, year of diagnosis, and marital status were significant independent predictors of survival…

According to the site of involvement, Solitary plasmacytoma (SP) can be divided into 2 types:

  • solitary bone plasmacytoma (SBP) and
  • solitary extramedullary plasmacytoma (SEP).

SBP accounts for about 70% of SP, and most commonly occurs in the axial skeleton.[] The median age at diagnosis ranges from 55 to 60 years with male predominance.[]Patients with SBP have a worse prognosis than SEP cases.[] Additionally, patients with extremity SBP have a better prognosis than spinal SBP cases.[]…

Although there are many advanced treatment methods for SBP, radiotherapy remains the primary therapy.[] Surgery is usually performed to treat SBP or prevent its complications.[] However, the role of surgery in increasing survival remains unknown. Moreover, chemotherapy for treatment of SP is still controversial…

Based on the results of multivariate cox regression analysis (Table (Table3),3), age <60 years and radiotherapy performed were significantly associated with a better OS and CSS…

Surgery, radiotherapy and chemotherapy are currently used in SP, but radiotherapy is widely recognized as the mainstream treatment.[,] We also found radiotherapy could significantly prolong the OS and CSS of extremity SBP.

The role of surgery in survival benefits for SBP remains unknown. This study first revealed that surgery did not improve survival in patients with extremity SBP. Furthermore, compared with radiotherapy alone, surgery combined with radiotherapy did not significantly prolong the life of patients (data not shown). Evidence also showed that high local control rates can be achieved with radiotherapy alone.[]—

Patients with radiotherapy and age ≤60, had a relatively better prognosis. Although no evidence showed that surgery or chemotherapy could prolong the survival of extremity SBP, further researches are needed to confirm this finding. To conclude, radiotherapy is the mainstream treatment for extremity SBP…”





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