Challenges in the treatment of soft-tissue plasmacytoma: a retrospective analysis of 120 patients with extramedullary multiple myeloma.

IF 2.7 3区医学 Q3 ONCOLOGY Journal of Cancer Research and Clinical Oncology Pub Date : 2024-10-29 DOI:10.1007/s00432-024-05993-y

Dominik Zolnowski, Simone Karp, Paul Warncke, Jessica Zinn, Marcel Pannach, Regina Herbst, Annette Hänel, Anke Morgner, Stefan Ibach, Stephan Fricke, Mathias Hänel

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Abstract

Purpose: Despite the development of novel drugs and the widespread use of hematopoietic cell transplantation, the prognosis of patients (pts) with multiple myeloma and extramedullary involvement (soft-tissue plasmacytoma, STP) is rather unfavorable.

Methods: A retrospective analysis of 120 pts with STP treated between 2007 and 2022 was performed. The effects of demographic and clinical characteristics on treatment response, progression-free survival (PFS), and overall survival (OS) were evaluated.

Results: The rate of serological response to first-line STP treatment (at least partial remission) was 67%, and the rate of imaging response was 59%. With a median follow-up of 84.2 months, the median PFS was 10.5 months (primary STP: 20.2 months; secondary STP: 5.8 months), and the median OS was 24.5 months (primary STP: 34.5 months; secondary STP: 12.4 months). Based on the multivariate regression analysis, secondary STP (HR_PFS 2.75; HR_OS 2.63) and organ involvement (HR_PFS 1.45; HR_OS 1.68) were found to be negative prognostic factors of both PFS and OS. In a prognostic model, pts with at least one of these factors had a significantly worse PFS (HR_PFS 3.31) and OS (HR_OS 3.45) than those with none risk factor.

Conclusion: In pts with STP, risk-adapted treatment strategies including immunotherapies and cell therapies are urgently required.

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治疗软组织浆细胞瘤的挑战：对120名髓外多发性骨髓瘤患者的回顾性分析。

目的：尽管新药层出不穷，造血细胞移植也得到广泛应用，但多发性骨髓瘤髓外受累（软组织浆细胞瘤，STP）患者（pts）的预后却相当不乐观：对2007年至2022年间接受治疗的120名STP患者进行了回顾性分析。方法：对2007年至2022年间接受治疗的120例STP患者进行了回顾性分析，评估了人口统计学和临床特征对治疗反应、无进展生存期（PFS）和总生存期（OS）的影响：结果：STP一线治疗的血清学应答率（至少部分缓解）为67%，影像学应答率为59%。中位随访时间为84.2个月，中位PFS为10.5个月（一线STP：20.2个月；二线STP：5.8个月），中位OS为24.5个月（一线STP：34.5个月；二线STP：12.4个月）。多变量回归分析发现，继发性 STP（HRPFS 2.75；HROS 2.63）和器官受累（HRPFS 1.45；HROS 1.68）是 PFS 和 OS 的负预后因素。在预后模型中，至少有上述一个因素的患者的PFS（HRPFS 3.31）和OS（HROS 3.45）明显差于无风险因素的患者：结论：对于 STP 患者，迫切需要包括免疫疗法和细胞疗法在内的风险适应性治疗策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cancer Research and Clinical Oncology 医学-肿瘤学

CiteScore

4.00

自引率

2.80%

发文量

577

审稿时长

2 months

期刊介绍： The "Journal of Cancer Research and Clinical Oncology" publishes significant and up-to-date articles within the fields of experimental and clinical oncology. The journal, which is chiefly devoted to Original papers, also includes Reviews as well as Editorials and Guest editorials on current, controversial topics. The section Letters to the editors provides a forum for a rapid exchange of comments and information concerning previously published papers and topics of current interest. Meeting reports provide current information on the latest results presented at important congresses. The following fields are covered: carcinogenesis - etiology, mechanisms; molecular biology; recent developments in tumor therapy; general diagnosis; laboratory diagnosis; diagnostic and experimental pathology; oncologic surgery; and epidemiology.