Ring chromosomes in hypodiploid and hypotetraploid clones from an elderly patient with plasma cell leukemia

We describe a 77-year-old woman who had with what appears to be the first case of plasma cell leukemia (PCL) with a ring chromosome of variable size. Of the three clones evident, two of them were abnormal: a 41,X,-X hypodiploid clone with rings of two different sizes, and a 81-82,XX hypotetraploid clone with a double-sized dicentric ring or variable double rings. Additional structural and numerical abnormalities included a 14q+ marker, deletions of two chromosomes 1 and monosomies 8 and 13, all previously reported in PCLs. Ring chromosomes have been associated with a poor prognosis, especially in elderly patients. The patient declined active treatment and died within 4 weeks of diagnosis.