Primary plasma cell leukemia: morphologic, immunophenotypic, and cytogenetic features of 4 cases treated with chemotherapy and stem cell transplantation

Johnson, Malisha R.; Del Carpio-Jayo, Daniel; Lin, Pei; Giralt, Sergio; Anderlini, Paolo; Champlin, Richard E.; Khouri, Issa F.; Vadhan-Raj, Saroj; Medeiros, L. Jeffrey; Bueso-Ramos, Carlos E.

doi:10.1016/j.anndiagpath.2005.12.011

« Previous Next »Annals of Diagnostic Pathology
Volume 10, Issue 5 , Pages 263-268, October 2006

Primary plasma cell leukemia: morphologic, immunophenotypic, and cytogenetic features of 4 cases treated with chemotherapy and stem cell transplantation

Malisha R. Johnson, DO
- Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Daniel Del Carpio-Jayo, MD
- Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Pei Lin, MD
- Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Sergio Giralt, MD
- Department of Bone Marrow Transplantation, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Paolo Anderlini, MD
- Department of Bone Marrow Transplantation, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Richard E. Champlin, MD
- Department of Bone Marrow Transplantation, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Issa F. Khouri, MD
- Department of Bone Marrow Transplantation, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Saroj Vadhan-Raj, MD
- Department of Cytokine and Supportive Oncology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
L. Jeffrey Medeiros, MD
- Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Carlos E. Bueso-Ramos, MD, PhD
- Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Corresponding author. Tel.: +1 713 792 6328; fax: +1 713 794 1800.

Abstract

Plasma cell leukemia (PCL) is a neoplastic disorder of plasma cells of which there are 2 forms, primary PCL and secondary PCL, the latter occurring in patients with a history of plasma cell myeloma. We describe 4 patients with primary PCL. In all cases, the bone marrow aspirate smears and biopsy specimens demonstrated a diffuse infiltrate of atypical plasma cells that were difficult to classify using morphologic criteria alone. Immunophenotypic studies showed that each case was positive for plasma cell–associated antigens (cytoplasmic immunoglobin, CD38, or CD138) and negative for CD20. Of 4 cases, 3 had complex karyotypes, including the t(11;14)(q13;q32) or del(11)(q13). Despite chemotherapy and the use of novel therapeutic agents and stem cell transplantation, all 4 patients had short survival.

Keywords: Plasma cell leukemia, Stem cell transplantation, Chemotherapy