Abstract
In this chapter, two challenging cases of plasma cell neoplastic diseases are presented. The first is a solitary plasmacytoma, diagnosed in a setting of POEMS syndrome (Dispenzieri, Am J Hematol 89(2):214–223, 2004). This illustrates the potential curative nature of radiation therapy in this rare disease. The second case is the more common multiple myeloma, treated with systemic chemotherapy and autologous peripheral blood stem transplantation, but with unusual spread to the central nervous system. The case presentations will be followed by a discussion of the salient clinical evaluation and management in each case, with a focus on the role of radiation therapy and the sequencing of various therapies applied in these unusual and challenging clinical scenarios.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Dispenzieri A. POEMS syndrome: 2014 update on diagnosis, risk-stratification, and management. Am J Hematol. 2014;89(2):214–23.
Glazebrook K, Guerra Bonilla FL, Johnson A, Leng S, Dispenzieri A. Computed tomography assessment of bone lesions in patients with POEMS syndrome. Eur Radiol. 2015;25(2):497–504.
Miest RY, Comfere NI, Dispenzieri A, Lohse CM, el-Azhary RA. Cutaneous manifestations in patients with POEMS syndrome. Int J Dermatol. 2013;52(11):1349–56.
Allam JS, Kennedy CC, Aksamit TR, Dispenzieri A. Pulmonary manifestations in patients with POEMS syndrome: a retrospective review of 137 patients. Chest. 2008;133(4):969–74.
Humeniuk MS, Gertz MA, Lacy MQ, Kyle RA, Witzig TE, Kumar SK, et al. Outcomes of patients with POEMS syndrome treated initially with radiation. Blood. 2013;122(1):68–73.
Chandrashekaran S, Dispenzieri A, Cha SS, Kennedy CC. Pulmonary morbidity improves after autologous stem cell transplantation in POEMS syndrome. Respir Med. 2015;109(1):122–30.
Karam C, Klein CJ, Dispenzieri A, Dyck PJ, Mandrekar J, D’Souza A, et al. Polyneuropathy improvement following autologous stem cell transplantation for POEMS syndrome. Neurology. 2015;84(19):1981–7.
Hodgson DC, Mikhael J, Tsang RW. Plasma cell myeloma and plasmacytoma. In: Halperin EC, Wazer DE, Perez CA, Brady LW, editors. Principles and practice of radiation oncology. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2013.
Tsang RW, Gospodarowicz MK, Pintilie M, Bezjak A, Wells W, Hodgson DC, et al. Solitary plasmacytoma treated with radiotherapy: impact of tumor size on outcome. Int J Radiat Oncol Biol Phys. 2001;50(1):113–20.
Bachar G, Goldstein D, Brown D, Tsang R, Lockwood G, Perez-Ordonez B, et al. Solitary extramedullary plasmacytoma of the head and neck--long-term outcome analysis of 68 cases. Head Neck. 2008;30(8):1012–9.
Ozsahin M, Tsang RW, Poortmans P, Belkacemi Y, Bolla M, Oner Dincbas F, et al. Outcomes and patterns of failure in solitary plasmacytoma: a multicenter Rare Cancer Network study of 258 patients. Int J Radiat Oncol Biol Phys. 2006;64(1):210–7.
D’Souza A, Lacy M, Gertz M, Kumar S, Buadi F, Hayman S, et al. Long-term outcomes after autologous stem cell transplantation for patients with POEMS syndrome (osteosclerotic myeloma): a single-center experience. Blood. 2012;120(1):56–62.
Mendenhall CM, Thar TL, Million RR. Solitary plasmacytoma of bone and soft tissue. Int J Radiat Oncol Biol Phys. 1980;6(11):1497–501.
Greipp PR, San Miguel J, Durie BG, Crowley JJ, Barlogie B, Blade J, et al. International staging system for multiple myeloma. J Clin Oncol Off J Am Soc Clin Oncol. 2005;23(15):3412–20.
Gangatharan SA, Carney DA, Prince HM, Wolf MM, Januszewicz EH, Ritchie DS, et al. Emergence of central nervous system myeloma in the era of novel agents. Hematol Oncol. 2012;30(4):170–4.
Gozzetti A, Cerase A, Lotti F, Rossi D, Palumbo A, Petrucci MT, et al. Extramedullary intracranial localization of multiple myeloma and treatment with novel agents: a retrospective survey of 50 patients. Cancer. 2012;118(6):1574–84.
Chen CI, Masih-Khan E, Jiang H, Rabea A, Cserti-Gazdewich C, Jimenez-Zepeda VH, et al. Central nervous system involvement with multiple myeloma: long term survival can be achieved with radiation, intrathecal chemotherapy, and immunomodulatory agents. Br J Haematol. 2013;162(4):483–8.
Leigh BR, Kurtts TA, Mack CF, Matzner MB, Shimm DS. Radiation therapy for the palliation of multiple myeloma. Int J Radiat Oncol Biol Phys. 1993;25(5):801–4.
Rades D, Hoskin PJ, Stalpers LJ, Schulte R, Poortmans P, Veninga T, et al. Short-course radiotherapy is not optimal for spinal cord compression due to myeloma. Int J Radiat Oncol Biol Phys. 2006;64(5):1452–7.
Kumar SK, Rajkumar SV, Dispenzieri A, Lacy MQ, Hayman SR, Buadi FK, et al. Improved survival in multiple myeloma and the impact of novel therapies. Blood. 2008;111(5):2516–20.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Tsang, R. (2017). Plasmacytoma and Multiple Myeloma. In: Dabaja, B., Ng, A. (eds) Radiation Therapy in Hematologic Malignancies . Springer, Cham. https://doi.org/10.1007/978-3-319-42615-0_6
Download citation
DOI: https://doi.org/10.1007/978-3-319-42615-0_6
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-42613-6
Online ISBN: 978-3-319-42615-0
eBook Packages: MedicineMedicine (R0)