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- Title
A Clinical Perspective on Plasma Cell Leukemia: A Single-Center Experience.
- Authors
Li, Andrew Y.; Kamangar, Farin; Holtzman, Noa G.; Rapoport, Aaron P.; Kocoglu, Mehmet H.; Atanackovic, Djordje; Badros, Ashraf Z.
- Abstract
Simple Summary: We evaluated the clinical features of primary and secondary plasma cell leukemia and the impact of current therapies. High-risk cytogenetics, low platelets, extramedullary disease and high LDH were independently associated with a poor outcome, with an overall survival of 11% at 5 years. Circulating plasma cells (CPCs) are detected in most multiple myeloma (MM) patients, both at diagnosis and on relapse. A small subset, plasma cell leukemia (PCL), represents a different biology and has a poor prognosis. In this retrospective analysis, we evaluated patients with primary (pPCL, n = 35) or secondary (sPCL, n = 49), with ≥5% CPCs and a smaller subset with lower CPCs of 1–4% (n = 20). The median age was 61 years; 45% were men and 54% were Black. High-risk cytogenetics were found in 87% and extramedullary disease in 47%. For the entire cohort, 75% received a proteasome inhibitor, 70% chemotherapy, 54% an immunomodulatory drug, 24% a daratumumab-based regimen and 26% an autologous stem cell transplant (ASCT). The treatments marginally improved the overall survival (OS) for pPCL vs. sPCL (13 vs. 3.5 months p = 0.002). However, the 5-year survival for the whole cohort was dismal at 11%. High-risk cytogenetics, low platelets, extramedullary disease and high LDH were independently associated with poor outcomes. Further research is urgently needed to expand the treatment options and improve the outcomes in PCL.
- Subjects
LEUKEMIA treatment; MULTIPLE myeloma; INVESTIGATIONAL drugs; TREATMENT effectiveness; LACTATE dehydrogenase; RETROSPECTIVE studies; DESCRIPTIVE statistics; LEUKEMIA; BLOOD platelets; PROTEASE inhibitors; CANCER chemotherapy; MONOCLONAL antibodies; SURVIVAL analysis (Biometry); EXTRAMEDULLARY diseases; GENETICS; OVERALL survival; IMMUNOMODULATORS; SYMPTOMS
- Publication
Cancers, 2024, Vol 16, Issue 11, p2149
- ISSN
2072-6694
- Publication type
Article
- DOI
10.3390/cancers16112149