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Ask The Nurse: Plasmacytomas

In this month’s Ask The Nurse blog, we decided to talk about all things plasmacytoma.

Ask The Nurse // 2nd October 2019

On the Myeloma Infoline and Ask The Nurse email services we find myeloma patients, carers and family members often get in touch for more information and reassurance when they experience uncommon symptoms and complications related to myeloma. Over the last few months, we have received a number of calls about plasmacytomas. Plasmacytomas can occur as both a potential precursor to myeloma and a complication of myeloma. This can cause some confusion and concern amongst patients. In this month’s Ask The Nurse blog, we decided to talk about all things plasmacytoma.

What is a plasmacytoma?

Plasmacytoma is the medical term for a localised build-up of abnormal plasma cells.

Plasma cells are a type of white blood cell which forms part of the immune system. The plasma cells associated with plasmacytomas are malignant (cancerous).

These malignant cells can occur inside the bone (bone plasmacytoma) or in the soft tissue (extramedullary plasmacytoma).

What are the different kinds of plasmacytoma and how are they treated?

Solitary plasmacytomas

Plasmacytomas can occur as a single mass of abnormal plasma cells without any signs of myeloma. When this happens the patient is diagnosed with a solitary plasmacytoma.

A person is diagnosed with a solitary plasmacytoma through tests and investigations such as a bone marrow biopsy, an imaging scan such as an X-ray/MRI, and blood tests.

Solitary plasmacytomas are uncommon, with only about 300 cases per year in the UK, and they make up less than 1% of all blood cancers.

Some patients diagnosed with a solitary plasmacytoma will go on to develop myeloma. In general, the risk of progression to myeloma is higher in patients with a solitary bone plasmacytoma (approximately 50% within 10 years) compared to those with a solitary extramedullary plasmacytoma (approximately 30% within 10 years). Patients with either type of solitary plasmacytoma are monitored regularly for signs and symptoms that may indicate progression to myeloma.

In very rare cases patients can have more than one plasmacytomas without any signs of myeloma. This is known as multiple solitary plasmacytomas.

Solitary plasmacytomas are most commonly treated using radiotherapy.

Plasmacytoma as a complication of myeloma

Plasmacytomas can occur as a complication of myeloma. When this happens, patients are diagnosed with myeloma and the plasmacytoma is treated as part of their myeloma.

In these cases, treatment for myeloma also works to kill the plasmacytoma cells.

Some patients can receive radiotherapy as part of their treatment but only if the plasmacytoma causes significant pain or complications.

Plasmacytoma as a sign of relapse

Although very rare we have received calls from patients experiencing plasmacytomas as an early sign of relapse. These patients talk about experiencing pain or noticing lumps appearing during remission which after investigation are found to be caused by the presence of a localised build-up of abnormal plasma cells.

Some of these patients worry that these new lumps are secondary cancers. In most cases, the lumps signify a relapse and the need for further  treatment, rather than a secondary cancer.

As with the plasmacytomas presenting at myeloma diagnosis, plasmacytomas at relapse are treated with anti-myeloma drugs.

Queries like these further highlight that the first signs of relapse are not always changes in blood test results. Therefore, make sure you tell your healthcare team about any changes you notice, including any increase in symptoms, new pain or lumps.

To learn more about solitary plasmacytomas you can read our “Solitary Plasmacytoma Infosheet”. You can also read about the common symptoms and complications of myeloma in our “Infopack for newly diagnosed patients” and our “Infopack for relapsed and/or refractory myeloma patients”

If you have any questions about plasmacytomas or any uncommon symptoms or complications, you can get in touch with us through the Infoline (0800 980 3332 (UK) or 1800 937 773 (Ireland)) or the Ask The Nurse email service.

Best Wishes,

The Myeloma UK Information Specialist Team

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