Skeletal Plasmacytoma: progression of disease and impact of local treatment; an analysis of SEER database.
BACKGROUND
Previous reports suggest an as yet unidentifiable subset of patients with plasmacytoma will progress to myeloma. The current study sought to establish the risk of developing myeloma and determine the prognostic factors affecting the progression of disease.


METHODS
Patients with plasmacytoma diagnosed between 1973 and 2005 were identified in the SEER database(1164 patients). Patient demographics and clinical characteristics, treatment(s), cause of death, and survival were extracted. Kaplan-Meier, log-rank, and Cox regression were used to analyze prognostic factors.


RESULTS
The five year survival among patients initially diagnosed with plasmacytoma that later progressed to multiple myeloma and those initially diagnosed with multiple myeloma were almost identical (25% and 23%; respectively). Five year survival for patients with plasmacytoma that did not progress to multiple myeloma was significantly better (72%). Age > 60 years was the only factor that correlated with progression of disease (p = 0.027).


CONCLUSIONS
Plasmacytoma consists of two cohorts of patients with different overall survival; those patients that do not progress to systemic disease and those that develop myeloma. Age > 60 years is associated with disease progression. Identifying patients with systemic disease early in the treatment will permit aggressive and novel treatment strategies to be implemented.
Jawad
Muhammad Umar
MU
Departments of Orthopaedics, University of Miami Miller School of Medicine, 1400 NW, 12th Avenue, Miami, FL 33136, USA. mjawad@med.miami.edu
Scully
Sean P
SP
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D018450:Disease Progression; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D009985:Orthopedics / Q000379:methods; D010954:Plasmacytoma / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D011878:Radiotherapy / Q000379:methods; D012189:Retrospective Studies; D018426:SEER Program; D016019:Survival Analysis; D055815:Young Adult