Guidelines on the Diagnosis and Management of Solitary Plasmacytoma of Bone (SBP) and Solitary Extramedullary Plasmacytoma (SEP)

6. Tables I - III

Table I. Levels of evidence and grades of recommendation.

Levels of evidence

Ia	Evidence obtained from meta-analysis of randomized controlled trials
Ib	Evidence obtained from at least one randomized controlled trial
IIa	Evidence obtained from at least one well-designed, non-randomized study, including phase II trials and case ± control studies
IIb	Evidence obtained from at least one other type of well-designed, quasi-experimental study, i.e. studies without planned intervention, including observational studies
III	Evidence obtained from well-designed, non-experimental descriptive studies. Evidence obtained from meta-analysis or randomized controlled trials or phase II studies which is published only in abstract form
IV	Evidence obtained from expert committee reports or opinions and/or clinical experience of respected authorities.

Grades of recommendation

Grade A
Evidence level Ia, Ib
Recommendation based on at least one randomized controlled trial of good quality and consistency addressing specific recommendation

Grade B
Evidence level IIa, IIb, III
Recommendation based on well conducted studies but no randomized controlled trials on the topic of recommendation

Grade C
Evidence level IV
Evidence from expert committee reports and/or clinical experiences of respected authorities.

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Table II. Clinical Features of SBP and SEP

	SBP	SEP
Age; median, yrs:	55	55
M:F:	2:1	3:1
Predominant site:	Axial skeleton, especially vertebrae	Head and neck
% with M protein:	60	<25
% developing MM:	>75	<30
% survival at 10 years:	40-50	70

Figures based on data of Bolek et al, 1986; Dimopoulos et al, 2000; Frassica et al, 1989; Galieni et al, 2000; Wilder et al, 2002

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Table III. Recommended Diagnostic Criteria for SBP and SEP

Solitary Bone Plasmacytoma

• single area of bone destruction due to clonal plasma cells
• histologically normal marrow aspirate and trephine
• normal results on skeletal survey, including radiology of long bones
• no anaemia, hypercalcaemia or renal impairment due to plasma cell dyscrasia
• absent or low serum or urinary level of monoclonal immunoglobulin
• no additional lesions on MRI scan of the spine

Solitary Extramedullary Plasmacytoma

• single extramedullary mass of clonal plasma cells
• histologically normal marrow aspirate and trephine
• normal results on skeletal survey, including radiology of long bones
• no anaemia, hypercalcaemia or renal impairment due to plasma cell dyscrasia
• absent or low serum or urinary level of monoclonal immunoglobulin