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CC BY-NC-ND 4.0 · South Asian J Cancer 2023; 12(03): 280-285
DOI: 10.1055/s-0043-57231
Original Article
Hematological Malignancies

Plasma Cell Leukemia—Clinicopathological Profile from a Tertiary Care Center in Western India

Poornima Manimaran
1   Gujarat Cancer Research Institute, Ahmedabad, Gujarat, India
,
Varnika Rai
1   Gujarat Cancer Research Institute, Ahmedabad, Gujarat, India
,
Rahul Ranka
1   Gujarat Cancer Research Institute, Ahmedabad, Gujarat, India
,
Jyoti Sawhney
2   Department of Oncopathology, Gujarat Cancer Research Institute, Ahmedabad, Gujarat, India
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Abstract

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Poornima Manimaran

Introduction Plasma cell leukemia (PCL) is very uncommon and aggressive neoplasm constituting 2 to 4% of all plasma cell dyscrasias. By definition, clonal plasma cells should make up 20% of peripheral blood or have an absolute plasma cell count of 2 × 109 cells/cu.mm. PCL can be primary or secondary. In this study, the clinicohematological features of PCL, and correlation of immunophenotypic profile and conventional therapies with overall survival was analyzed.

Materials and Methods This retrospective study involved PCL patients who were diagnosed across a 12-year period, from 2010 to 2021, at a tertiary care center in western India. Clinical, biochemical, peripheral smear, bone marrow aspirate, immunophenotyping, and molecular analysis were performed.

Results Total 39 PCL patients were included in the study among which 36 were primary PCL patients. Splenomegaly (10/27), hepatomegaly (6/26), and lymphadenopathy (5/23) were noted. At presentation, all patients had anemia (<11g/dL), thrombocytopenia (33/39), hypercalcemia (>11mg/dl) 10/33 (30.3%) and lytic lesions was noted in 18/26 (69.2%).

Immunophenotype of these patients showed CD 38 positivity, CD 138 positivity, CD56 positivity, and CD 117 negativity were 100, 62, 41.6, and 89%, respectively. Overall survival of our patients was 4.1 months and overall survival of patients treated with VTD (bortezomib, thalidomide, dexamethasone) and VCD (bortezomib, cyclophosphamide, dexamethasone) regimen was 3.4 and 4.1 months, respectively, which was not statically significant (p-value 0.816). CD117 and CD56 markers were also not having any prognostic significance (p-value 1.000 and 0.873, respectively).

Conclusion Because of rarity of the disease, prospective studies are very limited and hence management and outcome of the disease are difficult to analyze. The current treatment protocols have no survival advantage and hence newer therapeutic approach is mandatory to attain better outcome.

Keywords

plasma cell leukemia - immature plasma cells - circulating plasma cells - CD117 - CD56


Publication History

Article published online:
09 June 2023

© 2023. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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