Solitary Plasmacytoma Guidelines

Updated: Mar 10, 2021
  • Author: Suzanne R Fanning, DO; Chief Editor: Emmanuel C Besa, MD  more...
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Guidelines

Guidelines Summary

The National Comprehensive Cancer Network (NCCN) has released guidelines for the management of multiple myeloma that includes the following specific recommendations for treatment and surveillance of solitary plasmacytoma [33] :

  • Radiation therapy (40-50 Gy in 1.8–2.0 Gy/fraction) to involved field
  • Consider surgery if there is structural instability or neurologic compression

The NCCN recommends follow-up surveillance every 3-6 months that includes [33] :

  • Complete blood cell count with differential
  • Serum chemistry: creatinine, albumin, corrected calcium
  • Serum quantitative immunoglobulins, serum protein electrophoresis, with serum immunofixation electophoresis as needed
  • 24-hour urine for total protein, urine protein electrophoresis with urine immunofixation electophoresis as needed
  • Serum free light chain assay

The following tests should be completed as clinically indicated:

  • Serum lactate dehydrogenase (LDH) and beta-2 microglobulin levels
  • Bone marrow aspirate and biopsy
  • Skeletal survey
  • Whole-body MRI or low-dose CT or PET/CT scan 

In addition, the NCCN recommends yearly imaging of all plasmacytomas, preferably with the same technique used at diagnosis, for at least 5 years.