[Plasma cell leukemia induced to complete remission with negative minimal residual disease by qualitative PCR analysis after hyper-CVAD and high-dose melphalan followed by autologous peripheral blood stem cell transplantation].

Abstract

A 69-year-old Japanese man was diagnosed as having primary plasma cell leukemia. His malignant plasma cells had a chromosomal translocation t(11;14)(q13;q32) that created overexpression of cyclin D1. Two courses of VAD (vincristine, doxorubicin, dexamethasone) therapy failed to achieve complete remission. Three subsequent courses of hyper-CVAD (cyclophosphamide, vincristine, doxorubicin, dexamethasone) therapy successfully induced remission with negative FISH test for t(11;14)(q13;q32). Thereafter, the patient received high-dose melphalan (125 mg/m(2)) followed by autologous peripheral blood stem cell transplantation. Cyclin D1 that was present prior to the high-dose chemotherapy, was no longer detected by qualitative PCR analysis. Despite complete cytogenetic remission, the disease relapsed 6 months later, and the patient eventually died 16 months following the diagnosis. Plasma cell leukemia is a rare hematological malignancy with a poor prognosis. The treatment has not been standardized yet. The present case suggested the effectiveness of the combination of hyper-CVAD and high-dose chemotherapy followed by autologous peripheral blood stem cell transplantation. Nevertheless, because of the short remission duration, intensification using tandem high-dose chemotherapy or maintenance using new agents such as bortezomib and thalidomide should be considered for improving the prognosis.

• Authors: Naoko Hosono, Takahiro Yamauchi, Toru Nakamura, Tarou Yamashita, Takanori Ueda
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 35 Issue 3 Pg. 533-7 (Mar 2008) ISSN: 0385-0684 [Print] Japan
• PMID: 18347412 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Vincristine
• Dexamethasone
• Doxorubicin
• Cyclophosphamide
• Melphalan

Topics

• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Cyclophosphamide (therapeutic use)
• Dexamethasone (therapeutic use)
• Doxorubicin (therapeutic use)
• Humans
• Leukemia, Plasma Cell (drug therapy, genetics, surgery)
• Male
• Melphalan (therapeutic use)
• Peripheral Blood Stem Cell Transplantation
• Polymerase Chain Reaction
• Remission Induction
• Transplantation, Autologous
• Treatment Failure
• Vincristine (therapeutic use)