-
International Forum of Allergy &... Feb 2014This study reviews the published literature related to extramedullary sinonasal plasmacytomas. Clinical presentation, demographics, treatment, and outcomes of this... (Review)
Review
BACKGROUND
This study reviews the published literature related to extramedullary sinonasal plasmacytomas. Clinical presentation, demographics, treatment, and outcomes of this uncommon disease are reported.
METHODS
A systematic review of studies for sinonasal plasmacytomas from 1950 to 2012 was conducted. A PubMed database search, both for articles related to this condition along with bibliographies of those selected articles, was performed. Articles were examined for patient data that reported disease outcome.
RESULTS
Sixty-seven journal articles were included in this analysis, comprising a total of 175 cases. Radiotherapy was the most common treatment modality, used in 89 cases, followed by a combination of surgery and radiotherapy, and surgery alone. A total of 71.8% of patients were alive after a median follow-up of 39 months, independent of treatment modality. A combination of radiotherapy and chemotherapy was rarely used but had the best treatment outcome, with 88.9% of patients (8/9 patients) alive. Of the 3 most common treatment modalities, a combination of radiotherapy and surgery had the most favorable outcomes. Sixteen patients (9.1%) converted to multiple myeloma, with the majority of these patients (75.0%) receiving radiotherapy alone as their treatment modality.
CONCLUSION
This review contains the largest pool of sinonasal plasmacytoma patients to date and suggests aggressive radiotherapy is the most common treatment modality for this condition. Of the 3 most common treatment modalities, a combination of surgery and radiotherapy was shown to have the best survival outcomes.
Topics: Combined Modality Therapy; Humans; Nose Neoplasms; Paranasal Sinuses; Plasmacytoma; Survival Analysis; Treatment Outcome
PubMed: 24339430
DOI: 10.1002/alr.21254 -
International Journal of Hematology Dec 2012Fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) is a useful diagnostic tool for the staging of patients with multiple myeloma (MM). The aim of this... (Review)
Review
Fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) is a useful diagnostic tool for the staging of patients with multiple myeloma (MM). The aim of this study is to perform a systematic review of the usefulness of FDG-PET or PET/CT in monitoring response to treatment in patients with MM. A comprehensive computer literature search of the PubMed/MEDLINE, Scopus and Embase databases was carried out to identify relevant peer-reviewed articles on the use of FDG-PET or PET/CT in monitoring the response to treatment in patients with MM. Ten studies described investigations of the role of FDG-PET or PET/CT in monitoring the response to treatment in 690 patients with MM or solitary plasmacytoma: six of these were conducted prospectively, while four studies were retrospective. These articles were retrieved in full-text version and analyzed. Based on these findings from the literature, FDG-PET or PET/CT appear to be useful in the assessment of treatment response in patients with MM.
Topics: Aged; Bone Marrow; Bone Neoplasms; Clinical Trials as Topic; Combined Modality Therapy; Disease-Free Survival; Female; Fluorine Radioisotopes; Fluorodeoxyglucose F18; Glycolysis; Humans; Male; Meta-Analysis as Topic; Middle Aged; Multimodal Imaging; Multiple Myeloma; Neoplasm Staging; Plasmacytoma; Positron-Emission Tomography; Prognosis; Prospective Studies; Radiopharmaceuticals; Retrospective Studies; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 23135876
DOI: 10.1007/s12185-012-1215-6 -
The Cochrane Database of Systematic... Jun 2012POEMS (polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes) syndrome is a rare cause of demyelinating and axonal mixed neuropathy with monoclonal... (Review)
Review
BACKGROUND
POEMS (polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes) syndrome is a rare cause of demyelinating and axonal mixed neuropathy with monoclonal plasma cell proliferative disorder and multiorgan involvement. The pathogenesis of POEMS syndrome is not well understood, but overproduction of vascular endothelial growth factor (VEGF), probably secreted by plasmacytomas, is likely to be responsible for most of the characteristic symptoms. POEMS syndrome is a potentially fatal disease, and patients' quality of life deteriorates because of progressive neuropathy, massive pleural effusion or ascites, or thromboembolic events. There is a need for efficacious therapy to improve prognosis. This is the first update of a review first published in 2008.
OBJECTIVES
To assess the effects of treatment for POEMS syndrome.
SEARCH METHODS
We searched the Cochrane Neuromuscular Disease Group Specialized Register (23 February 2012), CENTRAL (2012, Issue 2), MEDLINE (January 1966 to February 2012), EMBASE (January 1980 to February 2012) and CINAHL Plus (January 1937 to February 2012) for all papers on POEMS syndrome
SELECTION CRITERIA
We sought all randomized and quasi-randomized controlled trials, and non-randomized controlled studies. Since we discovered no such clinical trials, we assessed and summarized all retrospective case series including five or more patients in the 'Discussion' section.
DATA COLLECTION AND ANALYSIS
Two review authors independently reviewed and extracted details of all potentially relevant trials with any treatment for POEMS syndrome. We then collated and summarized information on the outcome.
MAIN RESULTS
We found no randomized or non-randomized prospective controlled trials of treatment for POEMS syndrome. We summarized the results of retrospective case series containing five or more patients in the 'Discussion' section.
AUTHORS' CONCLUSIONS
There are no randomized or quasi-randomized controlled clinical trials of treatment for POEMS syndrome on which to base practice.
Topics: Adrenal Cortex Hormones; Hematopoietic Stem Cell Transplantation; Humans; Melphalan; POEMS Syndrome; Retrospective Studies; Thalidomide
PubMed: 22696361
DOI: 10.1002/14651858.CD006828.pub3 -
The Journal of Craniofacial Surgery Nov 2011There is a lack of consensus on the appropriate management of solitary plasmacytoma (SP) of the jaw. The aim of the present investigation was to provide scientific... (Review)
Review
BACKGROUND
There is a lack of consensus on the appropriate management of solitary plasmacytoma (SP) of the jaw. The aim of the present investigation was to provide scientific evidence for the optimal management of this disease through a systematic literature review.
METHODS
The included articles are published in English from 1948 to March 2011 and describe the population affected by SP of the jaw with site, clinical and radiographic features, special findings, initial diagnosis, treatment, and follow-up.
RESULTS
Fifty cases of SP of the jaw were identified. It typically presents as a single osteolytic lesion with no plasmocytosis involvement of bone marrow. Long bones and vertebrae are the most common sites of SP. Rarely, it involves the jaw occurring in only 4% of cases, mainly in the bone marrow-rich areas, angulus and ramus. Solitary plasmacytoma of the jaw has a worse prognosis than multiple myeloma (MM), and in half of the cases, it evolves in MM.
CONCLUSIONS
Because SP of bones is an uncommon tumor that rarely involves the jaws, through this article we emphasize early diagnosis and appropriate management to avoid progression to MM.
Topics: Aged; Biopsy; Bone Plates; Diagnosis, Differential; Humans; Male; Mandibular Neoplasms; Plasmacytoma; Radiography, Panoramic; Tomography, X-Ray Computed
PubMed: 22134311
DOI: 10.1097/SCS.0b013e31822ec79a -
The Cochrane Database of Systematic... Oct 2008POEMS (polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes) syndrome is a rare cause of demyelinating and axonal mixed neuropathy with multiorgan... (Review)
Review
BACKGROUND
POEMS (polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes) syndrome is a rare cause of demyelinating and axonal mixed neuropathy with multiorgan involvement and monoclonal plasma cell-proliferative disorder. The pathogenesis of POEMS syndrome is not well understood, but overproduction of vascular endothelial growth factor (VEGF), probably secreted by plasmacytomas, is likely to be responsible for most of the characteristic symptoms. POEMS syndrome is a potentially fatal disease, and patients' quality of life deteriorates because of progressive neuropathy, massive pleural effusion or ascites, or thromboembolic events. There is a need for efficacious therapy to improve prognosis.
OBJECTIVES
To provide the best available evidence from randomised controlled trials on treatment for POEMS syndrome.
SEARCH STRATEGY
We searched the Cochrane Neuromuscular Disease Group Trials Register (March 2008), MEDLINE (from January 1966 to March 2008), EMBASE (from January 1980 to March 2008) and CINAHL (from January 1982 to March 2008) for randomized controlled trials, quasi-randomized trials, historically controlled studies, and trials with concurrent controls. We adapted this strategy to search MEDLINE from 1966 and EMBASE from 1980 for comparative cohort studies, case-control studies and trials, and case series.
SELECTION CRITERIA
All randomized and quasi-randomized controlled trials, and non-randomized controlled studies were sought. Since we discovered no such clinical trials , we assessed and summarized all retrospective case series including five or more patients in the 'Discussion' section.
DATA COLLECTION AND ANALYSIS
Two authors independently reviewed and extracted details of all potentially relevant trials with any treatment for POEMS syndrome. We then collated and summarized information on the outcome.
MAIN RESULTS
We found no randomized or non-randomized prospective controlled trials of treatment for POEMS syndrome. We summarized the results of retrospective case series containing five or more patients in the Discussion section.
AUTHORS' CONCLUSIONS
There are no randomized or quasi-randomized controlled clinical trials of treatment for POEMS syndrome on which to base practice.
Topics: Humans; POEMS Syndrome
PubMed: 18843731
DOI: 10.1002/14651858.CD006828.pub2 -
Haematologica Jun 2004Perceiving the need for rigorous recommendations to facilitate decisions concerning the management of patients with multiple myeloma (MM), the Italian Society of... (Review)
Review
Management of multiple myeloma and related-disorders: guidelines from the Italian Society of Hematology (SIE), Italian Society of Experimental Hematology (SIES) and Italian Group for Bone Marrow Transplantation (GITMO).
OBJECTIVES
Perceiving the need for rigorous recommendations to facilitate decisions concerning the management of patients with multiple myeloma (MM), the Italian Society of Hematology (SIE) and the two affiliate societies (SIES and GITMO) commissioned a project to develop guidelines for the therapy of MM using evidence-based knowledge and consensus formation techniques.
METHODS
After a comprehensive systematic review of 1,450 papers, an Expert Panel formulated and graded sixty recommendations according to the supporting evidence. Evidence gaps were filled with twenty-two consensus-based statements. High grade recommendations (grade A) are reported below.
RESULTS
Treatment should be immediately initiated in MM patients with related organ damage: those patients aged below 65 years who do not have severe co-morbidities should receive autologous stem cell transplantation, while patients not candidates for autologous stem cell transplantation should receive oral melphalan and prednisone. Interferon-a should not be associated with conventional chemotherapy, but it can be offered with or without steroids as a maintenance therapy to patients who have reached a plateau phase. High-dose dexamethasone-containing regimens or high-dose dexamethasone alone are recommended as a first-line therapy when cytoreduction is urgently required (i.e., MM with spinal cord compression or with rapidly progressive renal failure). MM patients with moderate-to-severe anemia should receive erythropoietin, while patients with bone disease or osteopenia should receive long-term bisphophonates. Recommendations for the management of the clinical manifestations caused by the monoclonal protein (i.e. hyperviscosity, cast nephropathy, AL amyloidosis) and of solitary bone and extramedullary plasmacytoma were also elaborated.
CONCLUSIONS
A substantial proportion of clinical care for MM can be guided by evidence-based treatment recommendations.
Topics: Combined Modality Therapy; Disease Management; Evidence-Based Medicine; Humans; Italy; Multiple Myeloma; Societies, Medical
PubMed: 15194540
DOI: No ID Found