title: Multiparameter flow cytometry for staging of solitary bone plasmacytoma: new criteria for risk of progression to myeloma.
abstract: Solitary plasmacytoma represents a heterogeneous group of patients; approximately half develop multiple myeloma (MM) in 2 or 3 years, whereas others remain disease-free at 10 years. By definition, these patients do not have morphologic bone marrow (BM) plasma cell (PC) infiltration. Here, we investigated whether sensitive BM evaluation of patients with solitary bone plasmacytoma (SBP; n = 35) and extramedullary plasmacytoma (EMP; n = 29) through multiparameter flow cytometry (MFC) would unravel the presence of clonal PCs in otherwise disease-free BM, and whether BM clonality predicted higher risk of progression. BM clonal PCs were detected in 17 of 35 SBP (49%) and 11 of 29 EMP (38%) patients. Seventy-one percent of flow-positive vs only 8% of flow-negative SBP patients evolved to MM (median time to progression of 26 months vs not reached; hazard ratio, 17.4; P < .001). No significant differences were observed among EMP cases. Our results highlight the importance of MFC for sensitive BM evaluation of SBP patients, to predict risk of developing treatment-requiring MM and to plan disease monitoring.
authors.affiliation: Centro de Investigación Medica Aplicada, Clinica Universidad de Navarra, Pamplona, Spain;
authors.forename: Bruno
authors.initials: B
authors.lastname: Paiva
authors.affiliation: Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca, Instituto Mixto Consejo Superior de Investigaciones Científicas-Universidad de Salamanca Instituto de Biología Molecular y Celular del Cáncer (IBMCC), Salamanca, Spain;
authors.forename: Mauricio
authors.initials: M
authors.lastname: Chandia
authors.affiliation: Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca, Instituto Mixto Consejo Superior de Investigaciones Científicas-Universidad de Salamanca Instituto de Biología Molecular y Celular del Cáncer (IBMCC), Salamanca, Spain;
authors.forename: Maria-Belen
authors.initials: MB
authors.lastname: Vidriales
authors.affiliation: Hospital Universitario Central de Asturias, Oviedo, Spain;
authors.forename: Enrique
authors.initials: E
authors.lastname: Colado
authors.affiliation: Hospital Universitario Virgen del Rocio/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, Instituto de Biomedicina de Sevilla, Sevilla, Spain;
authors.forename: Teresa
authors.initials: T
authors.lastname: Caballero-Velázquez
authors.affiliation: Complejo Hospitalario de Leon, Leon, Spain;
authors.forename: Fernando
authors.initials: F
authors.lastname: Escalante
authors.affiliation: Hospital Clinico Universitario de Valladolid, Valladolid, Spain; and.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Garcia de Coca
authors.affiliation: Hospital Virgen de la Concha, Zamora, Spain.
authors.forename: Maria-Carmen
authors.initials: MC
authors.lastname: Montes
authors.affiliation: Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca, Instituto Mixto Consejo Superior de Investigaciones Científicas-Universidad de Salamanca Instituto de Biología Molecular y Celular del Cáncer (IBMCC), Salamanca, Spain;
authors.forename: Ramon
authors.initials: R
authors.lastname: Garcia-Sanz
authors.affiliation: Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca, Instituto Mixto Consejo Superior de Investigaciones Científicas-Universidad de Salamanca Instituto de Biología Molecular y Celular del Cáncer (IBMCC), Salamanca, Spain;
authors.forename: Enrique M
authors.initials: EM
authors.lastname: Ocio
authors.affiliation: Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca, Instituto Mixto Consejo Superior de Investigaciones Científicas-Universidad de Salamanca Instituto de Biología Molecular y Celular del Cáncer (IBMCC), Salamanca, Spain;
authors.forename: Maria-Victoria
authors.initials: MV
authors.lastname: Mateos
authors.affiliation: Centro de Investigación Medica Aplicada, Clinica Universidad de Navarra, Pamplona, Spain;
authors.forename: Jesus F
authors.initials: JF
authors.lastname: San Miguel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000628:therapy; D005260:Female; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging / Q000379:methods; D010954:Plasmacytoma / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors