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The predictive value of serum myeloma protein in solitary plasmacytoma

Radiation Oncology Journal 2020년 38권 2호 p.129 ~ 137
장원익, 고현강, 윤성수, 김한수, 엄근용, 김일한,
소속 상세정보
장원익 ( Chang Won-Ick ) - Seoul National University College of Medicine Department of Radiation Oncology
고현강 ( Koh Hyeon-Kang ) - Konkuk University Medical Center Department of Radiation Oncology
윤성수 ( Yoon Sung-Soo ) - Seoul National University College of Medicine Department of Internal Medicine
김한수 ( Kim Han-Soo ) - Seoul National University College of Medicine Department of Orthopedic Surgery
엄근용 ( Eom Keun-Yong ) - Seoul National University Bundang Hospital Department of Radiation Oncology
김일한 ( Kim Il-Han ) - Seoul National University College of Medicine Department of Radiation Oncology

Abstract


Purpose: To identify the clinical usefulness of serum M protein and to establish a rationale for regular follow-up with serum protein electrophoresis in solitary plasmacytoma.

Materials and Methods: Sixty-nine patients with solitary plasmacytoma and solitary plasmacytoma with minimal marrow involvement according to the International Myeloma Working Group criteria were retrospectively reviewed.

Results: At a median follow-up of 6.2 years, 5-year local control (LC), 5-year multiple myeloma-free survival (MMFS), 5-year failure-free survival (FFS), and 5-year overall survival (OS) were 82.6%, 44.1%, 41.8%, and 85.1%, respectively. Among the patients whose initial serum M protein was present or not evaluated, 37.3% of patients showed disappearance of serum M protein after various treatment. MMFS of these patients were comparable to non-secretory plasmacytoma with undetectable levels of M protein, and significantly better than patients with persistent M protein. Increase of serum M protein ≥0.1 g/dL was most predictive of treatment failure with area under the curve of 0.731.

Conclusion: Patients who eventually showed persistence of serum M protein after treatment showed worse MMFS and FFS compared to those whose serum M protein disappeared or who had initially non-secretory disease. The increase of serum M protein level ≥0.1 g/dL from current nadir was predictive of treatment failure. Therefore, regular follow-up with serum M protein is highly recommended especially unless the patient had initially non-secretory disease.

키워드

Plasmacytoma; Myeloma protein; Risk factor; Radiotherapy

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