Canterbury DHB
Patients may present with a solitary bone lesion. This is most often in the vertebrae, pelvis, femur and humerus. 75% will have a low concentration of monoclonal protein, usually <10 g/L. Serum levels of normal immunoglobulins are normally preserved. Serum free light chain analysis may also be abnormal. Bone marrow aspirate and trephine is normal. Skeletal survey and MRI of spine and pelvis should confirm that there is only one diseased area. By definition there should be no other ROTI.
Local radiotherapy 40-50 Gy is the treatment of choice. Follow-up shows that 50% of patients will develop myeloma by the 5 year time point. Most patients eventually transform to myeloma, but 30% remain disease-free at 10 years.
Topic Code: 5611