What are the NCCN guidelines on the treatment of solitary plasmacytoma?

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

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.


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