Hill et al developed a simple model for predicting the risk of a solitary plasmacytoma of bone progressing to myeloma. This can help to identify a patient who may benefit from more aggressive management. The author are from St. James’s Institute of Oncology in Leeds.
Patient selection: solitary plasmacytoma
Parameters:
(1) multiparameter flow cytometry of bone marrow taken distant from primary lesion
(2) urinary light chains (ULC)
Parameter
Finding
Points
flow cytometry
no occult marrow disease
0
occult marrow disease present
1
urinary light chains
absent
0
present
1
where:
• It might be interesting to see if serum light chain assays would be helpful.
• Detection of plasma cells in the bone marrow by flow cytometry can be a challenge.
total score =
= SUM(points for both parameters)
Interpretation:
• minimum score: 0
• maximum score: 2
Score
Risk of Progression
5 Year Progression Free
0
low
90%
1 or 2
high
20%
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