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Primary plasma cell leukemia: report of 17 new cases treated with autologous or allogeneic stem-cell transplantation and review of the literature.

Abstract
Primary plasma cell leukemia (PPCL) is a rare hematologic malignancy characterized by the proliferation of plasma cells in blood, bone marrow, and other organs in the absence of established multiple myeloma. PPCL has a poor prognosis when treated with conventional therapy for multiple myeloma. We describe here 17 new cases of PPCL who underwent stem-cell transplantation (SCT) (2 cases observed by the authors and 15 cases from the International Bone Marrow Transplant Registry [IBMTR]). The first case was diagnosed in a 21-year-old male who presented with leukocytosis and acute renal failure. He was treated with hyper-CVAD, entered complete remission, and then proceeded to high-dose chemotherapy with peripheral stem-cell support. He is currently in complete remission 23 months after initial diagnosis and 19 months after autologous SCT. The second case was observed in a 31-year-old male who presented with leukocytosis and hepatic infiltration with plasma cells. He was treated with VAD chemotherapy and underwent allogeneic bone marrow transplantation from his HLA-identical sister. He remained in complete remission for 3 years and then developed progressive refractory disease, dying 7 years after the initial diagnosis. In addition to these 2 cases, 15 further unpublished cases of PPCL from the IBMTR are reported here (treated between 1993 and 2001, 6 by autologous and 9 by allogeneic transplantation). Finally, the features of PPCL, the outcome, published data of SCT for PPCL, and indications for treatment are discussed.
AuthorsSteven Saccaro, Rafael Fonseca, Diana M Veillon, James Cotelingam, Mary L Nordberg, Christopher Bredeson, Jonathan Glass, Reinhold Munker
JournalAmerican journal of hematology (Am J Hematol) Vol. 78 Issue 4 Pg. 288-94 (Apr 2005) ISSN: 0361-8609 [Print] United States
PMID15795922 (Publication Type: Case Reports, Journal Article, Review)
Topics
  • Adult
  • Humans
  • Leukemia, Plasma Cell (therapy)
  • Male
  • Middle Aged
  • Prognosis
  • Stem Cell Transplantation
  • Transplantation, Autologous
  • Transplantation, Homologous
  • Treatment Outcome

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