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Plasma cell leukemia: case report of a rare and aggressive variant of multiple myeloma
1Department of Medical Oncology, Khyber Teaching Hospital and Post-Graduate Medical Institute, Hayatabad Medical Complex, Peshawar.
Abstract:
Plasma cell leukemia (PCL) is a rare disease and is the least common variant of multiple myeloma accounting for 2-3% of all plasma cell dyscrasias. We report a patient who presented with history of high grade fever, weakness, palpitations, loss of appetite, bone pains and mental confusion for twenty days. Initial evaluation revealed plasmacytosis with blood plasma cell count of 5184/cumm. His hemoglobin (Hb) was 11.3 gm/dl, platelets were 75000/cumm and total leucocyte count (TLC) was 21600/cumm (24% plasma cells). Bone marrow examination revealed >60% plasmablasts. Serum LDH was high at 3117 U/L and serum calcium was also elevated at 13.9 mg/dl. A diagnosis of PCL was made and the patient was started on treatment for hypercalcaemia with Melphalan/Prednisolone regime along with supportive care. Patient deteriorated very rapidly despite treatment and died on the eighth day. A detailed report of this case and a review of PCL is presented here.
Insights
Plasma cell leukemia (PCL), a rare multiple myeloma variant, presents aggressively. This case highlights rapid deterioration despite treatment, emphasizing PCL
Area of Science:
- Hematology
- Oncology
Background:
- Plasma cell leukemia (PCL) is a rare and aggressive variant of multiple myeloma.
- It accounts for 2-3% of all plasma cell dyscrasias.
Observation:
- A patient presented with fever, weakness, bone pain, and confusion.
- Initial tests showed high plasma cell counts (5184/cumm), anemia, thrombocytopenia, and elevated LDH and calcium levels.
- Bone marrow examination confirmed over 60% plasmablasts.
Findings:
- The patient was diagnosed with PCL and treated with Melphalan/Prednisolone for hypercalcemia.
- Despite treatment, the patient experienced rapid deterioration and died within eight days.
Implications:
- This case underscores the aggressive nature and poor prognosis of PCL.
- It highlights the critical need for prompt diagnosis and effective therapeutic strategies for PCL patients.
