Plasma cell leukemia: a report on 15 patients.

Area of Science:

• Hematology
• Oncology

Background:

• Plasma cell leukemia (PCL) is the leukemic variant of multiple myeloma.
• PCL diagnosis requires plasmacytosis > 2 x 10(9)/l and clonal plasma cell proliferation.
• PCL exists as primary (de novo) or secondary (from multiple myeloma) forms.

Purpose of the Study:

• To compare the clinical characteristics and outcomes of primary and secondary plasma cell leukemia.
• To determine the incidence of PCL in multiple myeloma and acute leukemia cases.

Main Methods:

• Retrospective analysis of 8 primary PCL cases and 7 secondary PCL cases diagnosed between 1974 and 1988.
• Comparison of clinical features, laboratory values, and survival between primary and secondary PCL groups.
• Evaluation of treatment responses to conventional therapies.

Main Results:

• Incidence of primary PCL was 2.6% among multiple myeloma cases and 0.9% among acute leukemia cases.
• Clinical characteristics, including age, bone pain, organomegaly, and bone lesions, were similar between primary and secondary PCL.
• Median survival was significantly different: 7 months for primary PCL versus 1 month for secondary PCL.
• Primary PCL patients showed better response rates to conventional myeloma therapy compared to secondary PCL patients.

Conclusions:

• Plasma cell leukemia shares clinical similarities but differs in prognosis based on its primary or secondary origin.
• Primary PCL offers a better median survival and treatment response compared to secondary PCL.
• Further research into novel therapeutic strategies for secondary PCL is warranted.