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Case Reports in Oncology 2024Non-secretory multiple myeloma (NSMM) is a rare form of multiple myeloma (MM) that is often difficult to detect and has not yet been well characterized. This is due to...
INTRODUCTION
Non-secretory multiple myeloma (NSMM) is a rare form of multiple myeloma (MM) that is often difficult to detect and has not yet been well characterized. This is due to the lack of production or the presence of monoclonal protein (MP) levels below levels detectable by testing such as serum/urine electrophoresis and immunofixation.
CASE PRESENTATION
Two patients of ours were being treated for MM with typical courses of systemic therapy. By the third-line therapy, both developed an extramedullary mass, one in the pelvis and the other in the neck. In both cases, blood work showed no measurable MP, normal free light chain levels, and unremarkable skeletal surveys. Secondary malignancies were suspected due to the clinical presentation in each case, and biopsies confirmed the presence of non-secretory plasmacytomas. Both patients were only treated with localized radiotherapy with a total dose of 2,000 cGy in 5 fractions over 1 week. Ultimately, this resolved the original masses with no residual tumors. No changes had to be made to their systemic therapies, and both patients remained stable.
CONCLUSION
NSMM relapse is not unusual and should be suspected in patients with relapsed refractory disease. Relapse should be confirmed by a tissue biopsy, and secondary malignancies should be ruled out. Radiotherapy is an excellent option to treat localized relapse and preserve the current line of systemic anti-myeloma therapy.
PubMed: 38444889
DOI: 10.1159/000536675 -
Frontiers in Medicine 2024Multiple myeloma (MM) is one of the most common hematological malignancies globally, and it is projected to increase in the coming years. It occurs more frequently in...
BACKGROUND
Multiple myeloma (MM) is one of the most common hematological malignancies globally, and it is projected to increase in the coming years. It occurs more frequently in males and affects older individuals. Presenting symptoms can range from being asymptomatic to severely debilitating. The objective of this study was to determine the epidemiology, clinical features, and prognostic outcomes of patients with MM in the only tertiary cancer hospital in Qatar.
METHODS
Patients with symptomatic myeloma diagnosed at the National Center for Cancer Care and Research in Qatar between 2007 and 2021 were included. Data on demographics, laboratory work, bone marrow analysis, radiology, and given treatment were collected. Descriptive statistics, survival curves, and multivariable cox regression were used to identify independent mortality risk factors.
RESULTS
During the study period of 15 years, a total of 192 patients were diagnosed with MM. The incident rate of myeloma cases in 2021 was 8 patients per million. The median age of patients was 57 years [range 22-88], with 68% being above the age of 50 years at diagnosis. The majority of patients were male (71%) and (85%) were expats. At the time of diagnosis, most patients [ = 169 (88%)] had bone lesions, and 27% had extramedullary plasmacytoma. Anemia, hypercalcemia, and spinal cord compression were reported in 53%, 28%, and 7% of patients, respectively, at presentation. The monoclonal immunoglobulin subtypes were IgG, IgA, and free light chain in 52%, 16%, and 26% of patients, respectively. The overall median survival was 103 months (95% CI 71-135 months). In a multivariate cox-regression analysis for risk factors, only high serum calcium (≥ 2.7 mmol/L) was associated with increased mortality (HR: 2.54, 95% C.I.: 1.40-4.63, = 0.002). Patients who received an autologous stem cell transplant (ASCT) had significantly better overall survival.
CONCLUSION
In this comprehensive study of patients with MM treated in a country with a small and young general population, centralized hematology care, and free cancer care, we found a low but increasing incidence of MM and a good overall survival. Hypercalcemia was confirmed as a negative risk factor. ASCT had a significant positive impact on survival and should be provided to all patients eligible for this treatment, even in the era of novel agents.
PubMed: 38444413
DOI: 10.3389/fmed.2024.1338552 -
Annales de Dermatologie Et de... Mar 2024
Topics: Humans; Hodgkin Disease; Plasmacytoma; Lymphadenopathy; POEMS Syndrome; Cell Proliferation
PubMed: 38442467
DOI: 10.1016/j.annder.2024.103256 -
Indian Journal of Otolaryngology and... Feb 2024Tongue extramedullary plasmacytoma (EMP) with regional lymph node metastases is a very rare pathology. Despite being a rare entity, extramedullary plasmacytoma should be...
Tongue extramedullary plasmacytoma (EMP) with regional lymph node metastases is a very rare pathology. Despite being a rare entity, extramedullary plasmacytoma should be considered a differential diagnosis in cases of a mass or ulcer in the tongue. A 60-year-old lady presents with an ulcerative lesion over the right lateral border of the tongue with dimensions 3.5 × 2 cm for one year. Initially, on histopathological examination, a possibility of plasma cell neoplasm was suspected; on further IHC, serum protein electrophoresis, and radiological investigations, a definite diagnosis of solitary EMP of the right lateral border of the tongue with regional nodal metastases was confirmed. The patient received radiotherapy for the primary disease along with the involved neck nodal sites.
PubMed: 38440554
DOI: 10.1007/s12070-023-04185-3 -
Indian Journal of Otolaryngology and... Feb 2024Extraosseous plasmacytoma, a rare plasma cell neoplasm, was observed in a 52-year-old male with uncommon presentation in the oropharynx with cervical lymph node...
Extraosseous plasmacytoma, a rare plasma cell neoplasm, was observed in a 52-year-old male with uncommon presentation in the oropharynx with cervical lymph node involvement. The patient presented with dysphonia and left neck swelling. This case report primarily focuses on the management, resulting in a successful treatment through radiotherapy.
PubMed: 38440494
DOI: 10.1007/s12070-023-04228-9 -
Journal of Blood Medicine 2024Outcomes for patients with multiple myeloma has significantly improved through the years. This is mainly related to the use of novel agents.
INTRODUCTION
Outcomes for patients with multiple myeloma has significantly improved through the years. This is mainly related to the use of novel agents.
METHODS
This is a retrospective study that reviewed presentation and outcome of 139 patients with multiple myeloma at the Windsor Essex Regional Cancer Centre from Jan. 1, 2015 to Dec. 31, 2019. Median age was 71 years and most patients had higher risk disease (65.5% either R ISS stage II or III). 30% had high risk FISH for myeloma including del.17P, t (4:14), t (14:16) and Gain (1q21). In terms of presentation, 38.8% had anemia (hemoglobin <100g/L), 18.7% had hypercalcemia, 74.1% had skeletal lytic lesions, 38.8% had pathologic fracture and 17.3% had plasmacytoma.
RESULTS
Almost all (92%) of the patients were treated using at least one novel agent (proteasome inhibitor or immunomodulators [ImiDs]). Cyclophosphamide, bortezomib, and dexamethasone (CyBorD) was the most used treatment regimen (48.9%) followed by bortezomib, melphalan and prednisone (BMP) at 28.8% and lenalidomide, dexamethasone (LenDex) at 14.4%. With respect to response to therapy, 51.8% had at least Very good partial response (VGPR), while 9.4% had progressive disease. 33% had autologous stem cell transplant. After a median follow up of 2.4 years, median overall survival was 3.7 years. 2 years overall survival and relapse-free survival were 70% and 83%, respectively.
DISCUSSION
Our study showed comparable outcome for patients with multiple myeloma despite older age and higher risk disease. Outcome is expected to improve with the introduction of more novel agents.
PubMed: 38434928
DOI: 10.2147/JBM.S434055 -
Medicina Clinica Feb 2024
PubMed: 38423941
DOI: 10.1016/j.medcli.2023.12.019 -
EJHaem Feb 2024
PubMed: 38406542
DOI: 10.1002/jha2.821 -
Anais Brasileiros de Dermatologia 2024
Topics: Humans; Multiple Myeloma; Plasmacytoma; Skin Neoplasms; Male; Biopsy; Middle Aged; Immunohistochemistry; Female; Aged
PubMed: 38402013
DOI: 10.1016/j.abd.2022.10.018 -
Veterinary Sciences Feb 2024Despite their relatively long life-spans, reports of neoplasia in bats are rare and are limited to a handful of cases. In this report, we describe a 2-year-old female...
Despite their relatively long life-spans, reports of neoplasia in bats are rare and are limited to a handful of cases. In this report, we describe a 2-year-old female wild Cape serotine bat () that had been caught by a domestic cat and presented with a skin mass over the chest area. Histopathological analysis of a subsequent biopsy revealed proliferating sheets of neoplastic round cells, occasionally appearing to form packets, supported by a fine, fibrovascular stroma. Marked nuclear pleomorphism was seen, as well as a high mitotic count. Immunohistochemistry displayed positive labelling for MUM1 in the neoplastic cells. The diagnosis was extramedullary plasmacytoma (EMP); a neoplasm consisting of plasma cells derived from B lymphocytes. Due to a deteriorating condition, the bat was anaesthetised, and the mass was surgically removed two weeks later. However, the bat succumbed under the anaesthetic. Histopathological examination of the mass showed the same neoplastic cell population as observed in the biopsy; in addition, there was a locally extensive infiltration of neoplastic cells in the spleen and a mild presence of neoplastic cells in circulation. This is the first report of an EMP in a bat, and we compare the findings with that seen in dogs and cats.
PubMed: 38393090
DOI: 10.3390/vetsci11020072