Ceren BARLAS, Meltem DAĞDELEN, Fazilet Öner DİNÇBAŞ, Tuğrul ELVERDİ, Ayşe SALİHOĞLU

Successful Treatment of Bulky Abdominal Plasmacytomas With Radiotherapy and Pomalidomide

Extramedullary myeloma itself is a rare entity and treatment of recurrent extraosseous myeloma can be challenging during the prolonged disease course. We report a multiple myeloma (MM) patient with extramedullary bulky abdominal masses treated with palliative radiotherapy (RT) and concomitant pomalidomide.A 59-year-old woman diagnosed with MM presented with pancytopenia, widespread lytic bone lesions and intraperitoneal implants. The patient received multiple series of chemotherapy. Following autologous stem cell transplantation (ASCT), imaging studies displayed bulky abdominal masses. Due to the rapidly progressing symptoms, palliative RT 30 Gy in 15 fractions with concomitant pomalidomide was administered. Post-RT imagings showed near-complete regression.Extraosseous extramedullary MM has a poor prognosis and is an area of unmet clinical needs. Our report describes the treatment of a relapsed extramedullary myeloma case with RT and concomitant pomalidomide resulting in a near-complete response of disease inside the radiated area. To conclude, it was demonstrated that RT is an effective treatment modality to obtain symptom palliation and can be safely administered with an immunomodulatory drug.

PDF

___

Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA: a cancer journal for clinicians 2014; 64: 9-29.
Kyle RA, Gertz MA, Witzig TE, Lust JA, Lacy MQ, Dispenzieri A, et al., editors. Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clinic Proceedings; 2003: Elsevier.
Rajkumar SV, Kumar S, editors. Multiple myeloma: diagnosis and treatment. Mayo Clinic Proceedings; 2016: Elsevier.
Bhutani M, Foureau DM, Atrash S, Voorhees PM, Usmani SZ. Extramedullary multiple myeloma. Leukemia 2020; 34: 1-20.
Kyle R, Rajkumar SV. Criteria for diagnosis, staging, risk stratification and response assessment of multiple myeloma. Leukemia 2009; 23: 3-9.
Talamo G, Dimaio C, Abbi KK, Pandey MK, Malysz J, Creer MH, et al. Current role of radiation therapy for multiple myeloma. Frontiers in oncology 2015; 5: 40.
Yaneva M, Goranova-Marinova V, Goranov S. Palliative radiotherapy in patients with multiple myeloma. Journal of BU ON: official journal of the Balkan Union of Oncology 2006; 11: 43-48.
Ozsahin M, Tsang RW, Poortmans P, Belkacémi Y, Bolla M, Dinçbas FÖ, et al. Outcomes and patterns of failure in solitary plasmacytoma: a multicenter Rare Cancer Network study of 258 patients. International Journal of Radiation Oncology* Biology* Physics 2006; 64: 210-217.
Mendenhall CM, Thar TL, Million RR. Solitary plasmacytoma of bone and soft tissue. International Journal of Radiation Oncology* Biology* Physics 1980; 6: 1497-501.
1Gohil MH, Bhavsar DC, Suryanarayana U, Jetly DH. Plasmacytoma rectum extending to para rectal region. Journal of cancer research and therapeutics 2015; 11: 662.