NCCN Guidelines for Patients® | Multiple Myeloma

40 NCCN Guidelines for Patients ® : Multiple Myeloma, 2019 4 Treatment guide Solitary plasmacytoma Solitary plasmacytoma Guide 3. Primary treatment and follow-up for solitary plasmacytoma Cancer type Primary treatment Follow-up tests Solitary osseous plasmacytoma ª Radiation therapy ± surgery ª Testing every 3 to 6 months with: • CBC with differential and platelet count • Blood chemistry tests: creatinine, albumin, corrected calcium • 24-hour urine for monoclonal protein • UPEP and UIFE as needed • Serum quantitative immunoglobulins, SPEP, and SIFE as needed • Serum FLC assay as needed • Serum LDH and beta-2 microglobulin as needed • Bone marriow aspirate and biopsy as needed • Bone survey as needed or every year • Whole-body MRI, low-dose CT, or whole-body FDG PET/CT scan as needed Solitary extraosseous plasmacytoma ª Radiation therapy ± surgery ª Guide 3 shows the primary treatment options for a solitary plasmacytoma. A solitary plasmacytoma is when there is only one mass of myeloma cells. Patients with multiple myeloma can also have plasmacytomas. Guide 3 is specifically for people who have a solitary plasmacytoma and do not have multiple myeloma. This guide also shows the follow- up tests you should receive after treatment. Primary treatment is the main treatment used to rid the body of cancer. Treatment options are based on where the solitary plasmacytoma is located in the body. An osseous solitary plasmacytoma begins in bone marrow. An extraosseous solitary plasmacytoma begins in soft tissue outside the bone. Primary treatment Because there is only one cancer mass in a solitary plasmacytoma, treatment includes local therapies. Local therapy is given to treat a specific area in the body. For a solitary plasmacytoma, local therapy includes radiation therapy and surgery. Radiation therapy may be given with or without surgery as primary treatment. (See Part 3 on page 24 for more details about each treatment.)