AUTOLOGOUS BONE-MARROW TRANSPLANTATION FOR INTRAABDOMINAL EXTRAMEDULLARY PLASMACYTOMA

A patient with an extramedullary plasmacytoma of the omentum and ovari es is described. In spite of the presence of a very high concentration of paraprotein (103.5 g/l IgG k), bone marrow involvement was not dem onstrated either at presentation or during the course of the disease. After debulking surgery, chemotherapy (vincristine, prednisone, and cy clophosphamide) was initiated. Although this resulted in considerable improvement, the paraproteinemia persisted. After ten courses of chemo therapy there was recurrence of the tumor with involvement of the lymp h nodes in the right axilla. Chemotherapy was changed to a CHOP regime n (cyclophosphamide, adriamycin, vincristine, and prednisone), followe d by autologous bone marrow transplantation with the BEAM regimen (BCN U, etoposide, cytarabine, melphalan) as conditioning therapy. The pati ent was still in complete remission 1 year after transplantation. This case demonstrates that an extramedullary plasmacytoma may become mani fest as extensive but localized disease with high levels of paraprotei n, and that autologous bone marrow transplantation as a therapeutic mo dality can lead to prolonged complete remission of the disease.