How is extramedullary plasmacytoma (EMP) treated?

Updated: Dec 31, 2019
  • Author: Suzanne R Fanning, DO; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Based on the documented radiation sensitivity of plasma cell tumors, the accepted treatment of extramedullary plasmacytoma (EMP) is radiotherapy.

When a lesion can be completely resected, surgery provides the same results as radiotherapy.

Combined therapy (surgery and radiotherapy) is an accepted treatment depending on the resectability of the lesion. [10, 12, 13, 14, 15] In fact, combination treatment may provide the best results. [14]

The optimal radiation dose for local control is 40-50 Gy (depending on tumor size) delivered over 4-6 weeks. [13, 14, 15]

Because of the high rate of lymph node involvement, local nodess should be included in the radiation field. [13]

Adjuvant radiotherapy should be recommended to patients with positive surgical margins.

Chemotherapy may be considered for patients with refractory or relapsed disease. Regimens used for multiple myeloma can be considered. [45]

Adjuvant chemotherapy may be considered for patients with tumors larger than 5 cm, as well as those with high-grade histology.


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