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Dos Santos VM, Melim SP, de Faria PS, Passini VV, Duarte ML, Casasanta RA. Multiple myeloma and secondary plasma cell leukemia. Rom J Morphol Embryol 2016; 57:837-839. [PMID: 27833979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Plasma cell leukemia is very rare condition characterized by malignant proliferation of plasma cells in blood and bone marrow, which is aggressive and has a short survival even with conventional treatment. This ominous entity may be primary, or develops secondarily during the course of multiple myeloma. A 53-year-old Brazilian woman with multiple myeloma is described with bone marrow evaluation revealing 25% plasma cells. The quantification of plasma cell infiltration in bone marrow aspirate and immunohistochemistry study revealed consistent features of myeloma and plasma cell leukemia, and lambda light chain expression. Worthy of note was the absence of CD56 expression and the expression of CD20; moreover, 23% of circulating plasma cells were detected in peripheral blood smears. Therefore, the diagnosis of plasma cell leukemia was characterized and therapeutic schedules with dexamethasone, thalidomide, cisplatin, doxorubicin, cyclophosphamide, and etoposide were utilized. With significant clinical improvement, the patient is currently waiting for bone marrow transplant.
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2
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Robier C, Egger M, Wiesinger K, Aigner R, Neubauer M. Progression from light chain myeloma to secondary plasma cell leukemia accompanied by peripheral blood eosinophilia. Clin Chem Lab Med 2015; 53:e305-7. [PMID: 25951133 DOI: 10.1515/cclm-2015-0232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 04/13/2015] [Indexed: 11/15/2022]
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3
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Bansode YV, Admane V, Goroshi M, Katria P. Plasma cell leukaemia a rare cause of disproportionate anaemia in a patient presenting as CKD. J Assoc Physicians India 2014; 62:271-273. [PMID: 25327076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The anaemia in patient of chronic kidney disease is commonly related to secondary erythropoietin deficiency. When the severity of anaemia is disproportionate and associated with other haematological abnormalities like thrombocytopenia, then primary haematological disorder and secondary renal involvement must be considered. Renal involvement is common in haematologic disorder like Multiple Myeloma. The diagnosis of haematological disorder may be missed. This is a case of chronic kidney disease with disproportionate severe anaemia with bleeding diasthesis which ultimately turned out to be plasma cell leukaemia.
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Tamura S, Koyama A, Shiotani C, Kurihara T, Nishikawa A, Okamoto Y, Fujimoto T. Successful bortezomib/dexamethasone induction therapy with lenalidomide in an elderly patient with primary plasma cell leukemia complicated by renal failure and pulmonary hypertension. Intern Med 2014; 53:1171-5. [PMID: 24881743 DOI: 10.2169/internalmedicine.53.1672] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Primary plasma cell leukemia (PPCL) is a rare disease that progresses rapidly. In such cases, it is difficult to achieve remission, and early intensive chemotherapy is recommended. We herein describe the case of a 76-year-old man with PPCL complicated by renal failure and pulmonary hypertension. Bortezomib/dexamethasone induction therapy with lenalidomide was administered in association with continuous hemodiafiltration (CHDF). Complete remission was achieved after a single course of treatment, resulting in the cessation of CHDF. With the patient in remission, the administration of beraprost and bosentan resulted in improvements in the pulmonary hypertension. The results of this case report support the use of bortezomib/lenalidomide/dexamethasone combination therapy as an effective treatment for elderly PPCL patients with various complications.
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Affiliation(s)
- Shinobu Tamura
- Department of Hematology/Oncology, Kinan Hospital, Japan
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5
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Gentry M, Pettenati M, Pang CS. Biclonal light chain gammopathy with aberrant CD33 expression in secondary plasma cell leukemia. Int J Clin Exp Pathol 2013; 6:2224-2229. [PMID: 24133602 PMCID: PMC3796246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 08/28/2013] [Indexed: 06/02/2023]
Abstract
Plasma cell leukemia is a rare neoplastic proliferation of circulating plasma cells. Clonal proliferations of plasma cells, such as in plasma cell leukemia or plasma cell myeloma, are typically characterized by production of a monoclonal heavy and/or light chain immunoglobulin. We present a case of a secondary plasma cell leukemia arising from plasma cell myeloma with dual expression of lambda and kappa light chains along with aberrant expression of CD33, CD20, and dim CD56. This case emphasizes the importance of recognizing aberrant immunophenotypes in plasma cell leukemias and represents the first reported case of biclonal light chain expression in a secondary plasma cell leukemia.
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Affiliation(s)
- Michael Gentry
- Department of Pathology, Wake Forest University Baptist Medical Center Medical Center Boulevard, Winston Salem, NC 27157, USA
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6
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Mino T, Sakai A, Kinoshita M, Yoshida T, Mihara K, Imagawa J, Kimura A. [Successful treatment with bortezomib for a patient with plasma cell leukemia accompanied by severe hyperbilirubinemia]. Rinsho Ketsueki 2012; 53:92-96. [PMID: 22374531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A 59-year-old woman was admitted to our hospital with jaundice, renal dysfunction, anemia and hypercalcemia. Primary plasma cell leukemia (PCL) was diagnosed based on findings of IgA-λ type M-protein, 22% plasma cells in the bone marrow and 23.1% plasma cells of WBC in the peripheral blood. Because the total bilirubin (T.Bil) level increased even after the administration of prednisolone (PSL), dexamethasone and methylprednisolone, the patient was started on bortezomib (0.7 mg/m(2) on days 1, 4, 8 and 11 for 3 weeks) combined with PSL (40 mg/day). The level of T.Bil decreased and the patient's condition remarkably improved. We then increased the dose of bortezomib to 1.0 mg/m(2) in the second course, but discontinued treatment just after starting the third course because NCI-CTCAE Grade 3 peripheral neuropathy developed. According to the criteria of the International Myeloma Working Group, the response category was VGPR (=very good partial response) at 1 month after pausing treatment. We recommend these novel agents for PCL, which is an aggressive form of extramedullary plasma cell cancer.
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Affiliation(s)
- Tatsuji Mino
- Department of Hematology & Oncology, RIRBM, Hiroshima University
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7
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Sekiguchi Y, Shirane S, Imai H, Sugimoto K, Wakabayashi M, Sawada T, Chigira N, Ichikawa K, Komatsu N, Noguchi M. Response to low-dose bortezomib in plasma cell leukemia patients with malignant pleural effusion and ascites: a case report and a review of the literature. Intern Med 2012; 51:1393-8. [PMID: 22687849 DOI: 10.2169/internalmedicine.51.7061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Pleural effusion or ascites complicating plasmacytoma is rare and has a poor prognosis. A 70-year-old man was diagnosed as plasma cell leukemia and one course of ranimustine-vindesine, melphalan, and prednisolone followed by melphalan and prednisone (MP) maintained a very good partial response. After MP he was diagnosed to have pleural effusion and ascites as a complication of the plasmacytoma. Low-dose bortezomib caused disappearance of the malignant effusion. The malignant effusions recurred after the end of the second course of bortezomib. High-dose dexamethasone vincristine, doxorubicin, cyclophosphamide, and prednisone yielded no benefit, the patient died of Aspergillus pneumonia.
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8
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Jurczyszyn A, Zawirska D, Skotnicki AB. [Plasma cell leukemia: a highly aggressive monoclonal gammopathy with a very poor prognosis]. Przegl Lek 2011; 68:320-325. [PMID: 22039670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Plasma cell leukemia (PCL) is an aggressive variant of multiple myeloma and is characterized by the presence of greater then 20% absolute number of plasma cells circulating in the peripheral blood. PCL represents approximately 2-4% of all MM diagnosis and exists in two forms: primary PCL (PPCL, 60% of cases) presents de novo; whereas secondary PCL (SPCL, accounts for the remaining 40%) consists of a leukemic transformation in patients with a previously diagnosed MM. Because the mechanisms contributing to the pathogenesis of PCL are not fully understood, immunophenotyping, genetic evaluation (conventional karyotype, FISH, GEP and array-CGH), and immunohistochemistry are very important tools to investigate why plasma cells escape from bone marrow and become highly aggressive. Since treatment with standard agents and steroids is poorly effective, a combination of new drugs as part of the induction regimens and haematopoietic stem cell transplantation (autologous and allogeneic approaches) may overcome the poor prognosis exhibited by PCL patients.
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11
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Kalyani R, Kumar MLH. Plasma cell leukemia presenting as acute renal failure: a case report. INDIAN J PATHOL MICR 2007; 50:86-8. [PMID: 17474270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
Abstract
Plasma cell leukemia is a rare form of malignant plasma cell dyscrasia. It can occur as a primary form without prior evidence of multiple myeloma or as a secondary form which is a terminal event in multiple myeloma. A case of primary plasma cell leukemia presenting as acute renal failure is reported here.
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Affiliation(s)
- R Kalyani
- Department of Pathology, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka.
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Abstract
Renal involvement by a malignant infiltrative process is often suspected in patients with bilaterally enlarged kidneys and concurrent malignancies. Acute renal failure (ARF) can rarely occur secondary to such an infiltrative process. We present 2 cases in which ARF is attributable to malignant hematolymphoid infiltration. The first case involves diffuse, bilateral involvement of the kidneys by non-Hodgkin's lymphoma. The patient's renal function improved dramatically after the initiation of chemotherapy, clearly linking the development of ARF to the malignant process. In the second case, infiltration of the kidneys by plasma cell leukemia resulted in dialysis dependence. To our knowledge, this represents the first reported case of ARF attributable to documented renal infiltration by plasma cell leukemia. A review of the potential causes of renal failure in hematolymphoid malignancy, focusing on the direct impact of the infiltrative process and on the spectrum of renal disease in plasma cell dyscrasia, is presented.
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Affiliation(s)
- Steven E Lommatzsch
- Department of Internal Medicine, University of Virginia Health System, Charlottesville, VA 22908, USA
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Affiliation(s)
- Adam Humphries
- Department of Haematology, St Bartholomew's Hospital, West Smithfield, London, UK
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Saka B, Erten N, Oztürk G, Yilmaz C, Dogan O, Buyukbabani N, Besisik SK. Kappa light chain myeloma with initial cutaneous involvement. Ann Hematol 2006; 85:272-4. [PMID: 16425024 DOI: 10.1007/s00277-005-0064-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2005] [Accepted: 10/25/2005] [Indexed: 11/28/2022]
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Abstract
Involvement of cranial nerves is rare in plasma cell leukemia (PCL). Here, we report a case of PCL presenting with unilateral abducens paralysis. Cranial magnetic resonance imaging (MRI) disclosed a mass in the sphenoid sinus. Although the patient showed an initial response to chemotherapy, he died of disease progression 5 months later. Cytogenetic analysis showed translocation of chromosomes 11 and 14, t(11;14) (q13;q32), with additional complex abnormalities. This case implies an association between clinical manifestations and chromosomal abnormalities.
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MESH Headings
- Abducens Nerve Diseases/complications
- Aged
- Chromosome Aberrations
- Chromosomes, Human, Pair 11
- Chromosomes, Human, Pair 14
- Diplopia/etiology
- Disease Progression
- Fatal Outcome
- Humans
- Leukemia, Plasma Cell/complications
- Leukemia, Plasma Cell/diagnosis
- Leukemia, Plasma Cell/genetics
- Leukemia, Plasma Cell/physiopathology
- Liver/diagnostic imaging
- Magnetic Resonance Imaging
- Male
- Paralysis/complications
- Sphenoid Sinus/pathology
- Tomography, X-Ray Computed
- Translocation, Genetic
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Affiliation(s)
- Aya Nakaya
- Department of Internal Medicine, Hiratsuka City Hospital, Hiratsuka
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Abstract
We present the case of a patient who presented with small joint polyarthralgia and mild lymphocytosis. The patient was subsequently diagnosed to have plasma cell leukaemia. Skeletal survey showed bony lytic lesions in the hands and feet with no skeletal lesions elsewhere. The most common sites of bony involvement in plasma cell dyscrasia are skull, vertebrae, ribs and long bones. Although it is quite unusual for plasma cell leukaemia or myeloma to involve solely small joints of hands and feet, we suggest plasma cell dyscrasia should be kept in the differential diagnostic list for polyarthralgia in adults if usual causes are ruled out.
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Affiliation(s)
- F A Wandroo
- Department of Haematology, University Hospital Birmingham, Birmingham, UK.
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Abstract
Plasma cell disorders are associated with a wide spectrum of neurologic complications that predominantly involve the peripheral nervous system. Distinct clinical syndromes have been recognized, and antibodies to several glycoproteins of the peripheral nervous system have been identified. The main clinical, laboratory, immunologic, and pathologic features of neurologic complications that occur in patients with monoclonal gammopathies of unknown significance, multiple myeloma, plasmacytoma, plasma cell leukemia, Waldenstrom's macroglobulinemia, and immunoglobulin-related amyloidosis are summarized in this review. Knowledge of the pathogenesis in this group of disorders has increased in recent years, allowing better diagnosis and treatment.
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Affiliation(s)
- Jan Drappatz
- Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
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Madhavan S, Sasidharan PK, Krishnan R. Restrictive cardiomyopathy due to primary plasma cell leukemia. J Assoc Physicians India 2004; 52:826-7. [PMID: 15909860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
The causes of restrictive cardiomyopathy are numerous, of which neoplastic infiltration is also known. Plasma cell leukemia is considered as the, most severe form of multiple myeloma, is an extremely rare condition. Among them, primary plasma cell leukemia has got an incidence of one in one million only. We report a case summary of a patient who was admitted with clinical features suggestive of restrictive cardiomyopathy, the underlying disorder was primary plasma cell leukemia. With chemotherapy the restrictive physiology was relieved supporting the diagnosis of plasma cell infiltration in the myocardium. We report this case due to rarity of the disease itself and its rare presentation.
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Affiliation(s)
- S Madhavan
- Department of Medicine, Medical College, Calicut
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Abstract
Nearly all hematologic malignancies can occasionally present with or develop pleural effusions during the clinical course of disease. Among the most common disorders are Hodgkin and non-Hodgkin lymphomas, with a frequency of 20 to 30%, especially if mediastinal involvement is present. Acute and chronic leukemias, myelodysplastic syndromes, are rarely accompanied by pleural involvement. Furthermore, 10 to 30% of patients receiving bone marrow transplantation develop pleural effusions. In cases of hematologic pleural effusions, drug toxicity, underlying infectious, secondary malignant or rarely autoimmune causes should be carefully sought. In most cases, the pleural fluid responds to treatment of the primary disease, whereas resistant or relapsing cases may necessitate pleurodesis.
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Affiliation(s)
- Michael G Alexandrakis
- Department of Hematology, University Hospital of Heraklion, and Medical School, University of Crete, Greece
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Minauchi K, Fujie T, Matsubara N, Kasahara H, Ogura Y, Tamura M, Yamane Y, Tanaka M, Taneichi K. [Primary plasma cell leukemia (IgD-lambda) with hyperammonemia]. ACTA ACUST UNITED AC 2004; 93:139-41. [PMID: 14968586 DOI: 10.2169/naika.93.139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Famularo G, Armentano C, Mechelli A, De Laurenzi A, Nicotra GC. [Primary plasma cell leukemia. A fulminant case]. Recenti Prog Med 2003; 94:66-8. [PMID: 12908372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
Primary plasma cell leukemia is a rare variant of malignant monoclonal gammapathies with de novo presentation in the leukemic phase. Only few series enrolling more than 20 patients have been reported in the literature. The authors deal with a patient who had a fulminant presentation of primary plasma cell leukemia with fatal outcome. Diagnosis of primary plasma cell leukemia was established based on Kyle's criteria, which include an absolute plasma cell count greater than 2 x 10(9)/L or a relative plasma cell number comprising greater than 20% of peripheral blood cells. The patient died within three days of diagnosis because of Streptococcus pneumoniae septic shock and multiple organ failure. This case report is worth of note due to the rarity of primary plasma cell leukemia and also because fulminant presentation is not commonly recognized among patients with malignant gammapathies.
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Affiliation(s)
- Giuseppe Famularo
- Dipartimento di Medicina Interna e Specialistica, Azienda Ospedaliera San Camillo-Forlanini, Roma
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Johnston RE, Abdalla SH. Thalidomide in low doses is effective for the treatment of resistant or relapsed multiple myeloma and for plasma cell leukaemia. Leuk Lymphoma 2002; 43:351-4. [PMID: 11999568 DOI: 10.1080/10428190290006143] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Thalidomide is an effective treatment for relapsed multiple myeloma (MM), but is associated with a significant side effect profile at higher doses. In a recent study, only half of the enrolled patients were able to tolerate the maximum dose of 800 mg/day [Singhal, S., et al. (1999) "Antitumor activity of thalidomide in refractory multiple myeloma", New Engl. J. Med. 341, 1565-1571]. Moreover, the dose-response relationship has not been defined. We report our use of low dose thalidomide in a small cohort of 12 patients-eight with relapsed or refractory MM and four with plasma cell leukaemia (PCL). Five of the 12 (42%) patients had a partial response, showing a median fall in their PP/BJP of 80% (63-90%) at a median dose of 175 mg (100-300 mg) with negligible side effects. Three of four patients with PCL showed an impressive response to treatment with thalidomide as a single agent. No patient who failed to show any evidence of response at low dose (<150 mg/day) responded to higher doses. In this study, thalidomide induces a similar rate of response at a lower and better tolerated dose than previously reported and produced "best ever" responses in patients with resistant PCL.
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Affiliation(s)
- R E Johnston
- Department of Haematology, Imperial College Faculty of Medicine, St Mary's Hospital, London, UK
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O'Quinn K. Pathologic quiz case: a 43-year-old man with fatigue and night sweats. Arch Pathol Lab Med 2001; 125:838-40. [PMID: 11371247 DOI: 10.5858/2001-125-0838-pqcayo] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- K O'Quinn
- Department of Pathology, Medical University of South Carolina, Charleston, SC, USA
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25
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Huang-Kornic E. Chronic intermittent vomiting in a cat: a case of chronic lymphocytic-plasmacytic gastritis. Can Vet J 1999; 40:196-8. [PMID: 10086223 PMCID: PMC1539676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
A 3-year-old cat presented for chronic intermittent vomiting was diagnosed with chronic lymphocytic-plasmacytic gastritis via histological examination of an endoscopic gastric biopsy. The condition was effectively managed with prednisone. The author cautions against missing a diagnosis of alimentary lymphosarcoma without a full-thickness gastric biopsy.
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Hyodo T, Iwamasa K, Nakatani S, Yanagisawa K, Hasegawa H, Yasukawa M, Fujita S. [Plasma cell leukemia (IgA-lambda type) with polyclonal hypergammaglobulinemia]. Rinsho Ketsueki 1998; 39:680-5. [PMID: 9796403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
An 84-year-old woman was admitted to Ehime University hospital because of fever and generalized swelling of lymph nodes. On admission, she did not have any bone diseases. The laboratory data included a WBC count of 60,900/microliter, with 80.5% atypical plasma cells in the peripheral blood and 26.4% in the bone marrow. The patient's serum total protein was 9.3 g/dl with increased polyclonal gamma-globulin (62.4%). Serum levels of LDH (1,986 IU/l) and IL-6 (34.3 pg/dl) were also elevated. Immunofixation-electrophoresis detected a monoclonal band defined as IgA-lambda type, with a broad band of polyclonal immunoglobulin. Southern blotting analysis demonstrated rearranged monoclonal bands in the JH and J lambda genes. Based on these findings, plasma cell leukemia (IgA-lambda type) was diagnosed. The patient was treated with combination chemotherapy for acute lymphocytic leukemia and achieved complete remission. However, she died of aspergillus sepsis two months after admission. After chemotherapy, the patients IgG and IgM levels normalized but IgA still showed a slight increase. IL-6 also decreased, from 34.3 pg/dl to 10.2 pg/dl. To our knowledge, this report is the first in the literature concerning a case of plasma cell leukemia with polyclonal hypergammaglobulinemia.
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Affiliation(s)
- T Hyodo
- First Department of Internal Medicine, Ehime University School of Medicine
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27
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Aikawa S, Morimoto K, Kumagai T, Saitoh T, Tsuboi I, Sawada U, Horie T. [Plasma cell leukemia (IgG kappa) presenting bilateral neurosensory hearing loss and left sixth cranial nerve plasy]. Rinsho Ketsueki 1998; 39:506-11. [PMID: 9750458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
A 30-year-old man who had been given a diagnosis of IgG-kappa multiple myeloma by another hospital and treated with melphalan, prednisone, and cyclophosphamide 6 months earlier, was admitted to our hospitaly in July 1994 because of progressively impaired hearing in both ears, vertigo, and worsening fatigue. Peripheral blood examination showed a white blood cell count 25,000/microliter, with 77.5% atypical plasma cells. Examination at the time of hospitalization also revealed retinal hemorrhages and serum hyperviscosity. The diagnosis was plasma cell leukemia with hyperviscosity syndrome. Subsequent treatment consisted of vincristine, doxorubicine, and prednisone and repeated plasmapheresis. This resulted in a partial response and a reduction of serum viscosity but no reversal of hearing loss. One month after admission, left sixth cranial nerve plasy was demonstrated. Cranial computed tomography studies disclosed a tumoral mass in the sphenoid sinus. The patient received local radiotherapy and intensive chemotherapy, but exhibited no notable alleviation of his cranial nerve palsy. He died of septicemia and progressive disease in August 1994. This case was rare in that it involved plasma cell leukemia and bilateral neurosensory hearing loss associated with serum hyperviscosity and sixth cranial nerve plasy due to plasmacytoma within the sphenoid sinus.
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Affiliation(s)
- S Aikawa
- First Department of Internal Medicine, Nihon University School of Medicine
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28
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Heuberger L, Costello RT, Petit N, Fripiat F, Gastaut JA. First case of plasma-cell leukaemia co-existing with human immunodeficiency virus infection. Leukemia 1998; 12:103-4. [PMID: 9436929 DOI: 10.1038/sj.leu.2400890] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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29
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Pasqualetti P, Casale R. Monoclonal gammopathy of undetermined significance evolving directly in primary plasma cell leukemia. Biomed Pharmacother 1997; 51:284-5. [PMID: 9309249 DOI: 10.1016/s0753-3322(97)83544-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
A case of monoclonal gammopathy of undetermined significance (MGUS) which evolved directly into primary plasma cell leukemia (PCL) is reported. Even if MGUS and PCL represent the opposite aspects of the same immunoproliferative disorder, no previous cases of this direct evolution have been described, as stated by an accurate review of the specific literature. The patient abruptly developed PCL after five months from the discovery of a serum monoclonal spike, without any other clinical, laboratory and radiological abnormalities. The practical conclusions of this case report indicate that a patient with MGUS must be followed periodically and over an indefinite period, and that PCL must be considered into the possible evolution of MGUS.
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Affiliation(s)
- P Pasqualetti
- Department of Internal Medicine and Public Health, School of Medicine and Surgery, University of L'Aquila, Italy
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Cone LA, Lamb RB, Graff-Radford A, Rudder J, Bach SA, Hirschberg JA, Feller JF, Lynch RA. Pyomyositis of the anterior tibial compartment. Clin Infect Dis 1997; 25:146-8. [PMID: 9243048 DOI: 10.1086/514497] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Five oncology patients developed bacterial pyomyositis involving the anterior tibial compartment and resulting in compartment syndrome with ischemia and abnormalities of neuromuscular function. All patients were neutropenic and thrombocytopenic, and four were receiving or had recently received cancer chemotherapy. Three infections were due to gram-negative bacilli and two to Staphylococcus aureus. Appropriate antimicrobial therapy and surgical drainage in four patients resulted in the resolution of these infections with good residual muscle function. To our knowledge, primary pyomyositis has never previously been known to cause compartment syndrome.
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Affiliation(s)
- L A Cone
- Department of Medicine, Eisenhower Medical Center, Rancho Mirage, California 92270, USA
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31
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Yoshida K, Aida K, Horibe T, Kashimura T, Handa A, Matsuda A, Murohashi I, Jinnai I, Ino H, Bessho M, Takeuchi H, Saito M, Hirashima K, Kimura F. [Plasma cell leukemia associated with monocytosis]. Rinsho Ketsueki 1997; 38:604-9. [PMID: 9267165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A 51-year-old man was admitted to our hospital in December 1993, because of fatigue. Peripheral blood tests showed a WBC of 49,400/microliter with 36% plasma cells and 35% monocytes, Hb 14.5 g/dl, and Plt 137,000/microliter. Bone marrow aspirate revealed hypercellularity with 48.7% plasma cells and 22.4% monocytes. Plasma cells in blood were positive for CD38 and PCA-1. Serum calcium, IgA and M-CSF levels were elevated to 14.1 mg/dl, 2,337 mg/dl and 2.7 ng/ml, respectively. Immunoelectrophoresis of serum and urine revealed IgA lambda type M protein and lambda type Bence Jones protein, respectively. Rearrangements of immunoglobulin heavy chain and light chain were demonstrated by Southern blotting analysis. Plasma cell leukemia (IgA lambda type) was diagnosed. He was treated with combination chemotherapy and IFN-alpha and achieved complete remission. However, he suffered a meningeal relapse in February 1995, and died in April 1996. It seems likely that the enhanced production of M-CSF by myeloma cells and/ or activated B cells stimulated monocyte production.
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Affiliation(s)
- K Yoshida
- First Department of Internal Medicine, Saitama Medical School
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32
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Panizo Santos C, Cuesta Palomero B, Calasanz Abinzano MJ, Rifón Roca J, Rocha Hernando E. [Clinical and evolutive study of plasma cell leukemia. Apropos of 9 cases]. Rev Clin Esp 1997; 197:341-5. [PMID: 9280968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Nine patients were diagnosed with plasma cell leukemia (PCL) from 1982-1995 at our hospital. Seven patients had primary PCL and the other two patients a secondary from. In this study the clinical and analytical features are reported, as well as the therapy and response obtained in these patients. Also, the karyotype findings in bone marrow of four of these patients are reported. At diagnosis, the most common symptom was bone pain which was associated with osteolytic lesions or diffuse bone demineralization. Analytical features were similar to those reported in other series of patients with PCL. Different therapeutical regimens were used, and VAD was the most commonly employed. Two patients underwent consolidation therapy with autologous transplantation of hemopoietic stem cells. The mean survival time was 5.5 months. Although PCL prognosis associated with chemotherapy is still poor, myeloablative therapy with hemopoietic support can increase the survival length in these patients.
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Affiliation(s)
- C Panizo Santos
- Departamento de Genética, Facultad de Medicina, Universidad de Navarra
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33
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Abstract
We report 2 cases of plasma cell dyscrasia presenting with significantly elevated serum CA125 levels. The serum levels of CA125 from these patients correlated well with their serum M-protein levels. One patient had an IgG-kappa type extramedullary plasmacytoma with the culture supernatant from lymph node plasma cells showing a considerably high level of CA125 activity. The serum IgG fraction purified using a protein A column was devoid of any detectable CA125 activity, negating that the serum IgG M-protein from this patient might respond with a false-positive result in the CA125 immunoradiometric assay. The other patient had an IgG-lambda type plasma cell leukemia with the culture supernatant from peripheral mononuclear cells also showing a high level of CA125 activity. These observations may suggest that in plasma cell dyscrasias the CA125 antigen is spontaneously produced by tumor cells.
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Affiliation(s)
- T Iwasaki
- Second Department of Internal Medicine, Hyogo College of Medicine, Japan
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34
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Goncalvesová E, Uhliariková E, Vahancík A, Kohn R, Gyarfás J. [Hypercirculatory heart failure in a patient with plasmacytic leukemia]. Vnitr Lek 1995; 41:773-776. [PMID: 8553597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
High cardiac output failure/state (HCOF) is regular feature of some illnesses e.g. thiamine deficiency, hyperthyroidism, severe anemia, Paget's disease or arteriovenous fistulae. HCOF in multiple myeloma is reported quite rarely. 31-year-old man was admitted because of fatigue, dyspnea and subfebrilities. Heart rate was 116/min, sinus rythm blood pressure 110/60 mmHg. Chest film showed cardiomegaly with sings of interstitial pulmonary edema, echocardiography mild dilatation of the left ventricle with hyperkinetic wall motion and small pericardial effusion. Hemoglobin was 104 g/l, leukocyte count 13.5 x 10(9)/l with 30% of plasmatic cells. Serum protein electrophoresis demonstrated a monoclonal gammapathy, X ray studies of the skelet multiple osteolytic lesions. Diagnosis of plasmocytic leukemia-form of multiple myeloma was established and chemotherapy (vincristine + adriamycine + dexamethason) was started. Patient cardiac status deteriorated. Cardiac catheterisation demonstrated mean righ atrial pressure of 25 mmHg, mean pulmonary artery pressure of 28 mmHg and pulmonary artery wedge pressure of 24 mmHg. Co was 20.0 l/min (C.I. 11.5 l/min/m2). In continuing of chemotherapy and symptomatic therapy for heart failure patients status gradually improved and complete remission of the myeloma and normalisation of cardiac parameters was achieved. Heart failure in multiple myeloma patients has been attributed to amyloidosis of myocardium, hyperviscosity syndrome, co-existing CAD or anthracycline toxicity. HCOF should be considered in patients with clinical evidence of heart failure and normal left ventricular function.
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Affiliation(s)
- E Goncalvesová
- Katedra vnútorného lekárstva Institútu pre d'alsie vzdelávanie pracovníkov v zdravotníctve, Bratislava
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35
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Abstract
Diffuse osteosclerotic myeloma is very rare, and primary plasma cell leukemia with extensive osteosclerosis is even more rare. We describe a 71-year-old man who presented with severe anemia and dense widespread osteosclerosis similar to the X-ray finding of myelosclerosis. His peripheral blood showed 40% plasma cells. Bone marrow examination revealed heavy plasma cell infiltration with marked myelofibrosis and myelosclerosis. Protein electrophoresis and immunoelectrophoresis demonstrated an M-protein of IgG-lambda type. He was treated with cyclophosphamide, vincristine, and prednisolone for 10 months. A complete remission was obtained, with disappearance of M-protein and circulating plasma cells and normalization of complete blood counts, bone marrow picture, and biochemical parameters, as well as complete regression of myelofibrosis and osteosclerotic lesions. Unmaintained complete remission lasted for more than 1 year and he survived for more than 22 months. Our case indicated that one must include in the differential diagnosis of an osteosclerotic lesion the possibility of multiple myeloma, and that combination chemotherapy can induce a complete remission in this disease.
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Affiliation(s)
- M C Kuo
- Department of Internal Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C
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36
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Sakai C, Takagi T, Ishige K. Haematological remission and bone healing of refractory plasma cell leukaemia by chronic oral etoposide. Eur J Haematol Suppl 1995; 55:195-8. [PMID: 7672092 DOI: 10.1111/j.1600-0609.1995.tb00250.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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37
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Matýsková M, Krahulcová E, Buliková A, Novotná H. [Pleural effusion in plasmacytic leukemia]. Vnitr Lek 1995; 41:467-9. [PMID: 7571482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Multiple myeloma affects predominantly osseous spaces and the close vicinity of bones. A plasmacellular exudate is rare. The authors describe the course of plasmacellular leukaemia in a 68-year-old female patient where the first symptom of the disease was anaemia and a dextrolateral pleural exudate with a cytological finding of plasma cells. The exudate disappeared after the first cycle of chemotherapy and intrapleural administration of cytostatic. After the third cycle of chemotherapy remission of the disease was recorded which was, however, short. After three months' remission (six months after establishment of the diagnosis) the disease exacerbated violently, the dextrolateral exudate reappeared and gradually the insufficiency of the infiltrated bone marrow increased. The patient died one month after the relapse of the disease. The finding of a plasmacellular exudate must be considered the sign of a very poor prognosis and in that case very aggressive treatment is indicated.
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Affiliation(s)
- M Matýsková
- Oddĕlení klinické hematologie FN, Brno-Bohunice
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38
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Chuhjo T, Nakao S, Kyoda K, Machi T, Kitagawa S, Ohtake S, Matsuda T. Acute exacerbation of plasma cell leukemia associated with bacterial infection. Am J Hematol 1995; 49:260-1. [PMID: 7604827 DOI: 10.1002/ajh.2830490324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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39
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Abstract
We describe a case of plasma cell leukemia associated with myelofibrosis. A 60-year-old woman was admitted due to lumbago and monoclonal hypergammaglobulinemia. Peripheral blood showed about 40% of plasma-cell-like cells. A bone marrow aspiration was dry tap. The patient was diagnosed as having plasma cell leukemia with myelofibrosis by bone marrow biopsy. Plasma cell leukemia as well as myelofibrosis improved with combination chemotherapy using vincristine, pirarubicin, and dexamethasone. However, when plasma cell leukemia became resistant to chemotherapies, myelofibrosis also reappeared. This case strongly suggests the pathogenetic relationship between plasma cell leukemia and myelofibrosis.
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Affiliation(s)
- T Murayama
- Department of Medicine, Kobe University School of Medicine, Japan
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40
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Nakahashi E, Kuribayashi N, Tsuji N, Kawaguchi T, Hata H, Matsuzaki H, Shimizu K, Takatsuki K. [Primary plasma cell leukemia complicated with high-output cardiac failure and hyperammonemia]. Rinsho Ketsueki 1994; 35:756-60. [PMID: 7933562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
A 23-year-old male patient with plasma cell leukemia showed characteristic clinical features: accelerating heart failure and consciousness disturbance accompanied with an increase of plasma cells in peripheral blood. Evaluation of cardiac function revealed a hyperdynamic cardiac state with low somatic vascular resistance, indicating high-output cardiac failure. However no disorders causing high-output cardiac failure were found. Consciousness disturbance and hyperammonemia with serum amino acid abnormality of unknown origin were also demonstrated. After intensive combined chemotherapy (MVD + VAD), high-output cardiac failure and hyperammonemia improved with disappearance of plasma cells, suggesting that these symptoms were closely related with progression of plasma cell leukemia.
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Affiliation(s)
- E Nakahashi
- Second Department of Internal Medicine, Kumamoto University School of Medicine
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41
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Blot F, Herrmann JL, Brunengo P, Marsal L, Bekka R, Lang MP, Laaban JP. Septic shock and adult respiratory distress syndrome due to Listeria monocytogenes. Intensive Care Med 1994; 20:83-4. [PMID: 8163769 DOI: 10.1007/bf02425066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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42
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Malpica A, Phillips CC, Estrada RE, Banez EI. Plasma cell leukemia presenting as a pancreatic mass. Arch Pathol Lab Med 1993; 117:844-5. [PMID: 8343051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
A 62-year-old woman presented with a 3-week history of obstructive jaundice. Computed tomography of the abdomen showed marked enlargement of the head of the pancreas and a prominent pancreatic body, suggestive of a neoplasm with associated pancreatitis. The peripheral blood showed an increased number of plasma cells accounting for 50% of the leukocytes. Biopsy specimens of the pancreas, liver, and a peritoneal lymph node showed a diffuse infiltrate of typical and atypical plasma cells (50% of which had cytoplasmic IgG-lambda). Serum and urine protein electrophoresis revealed a monoclonal IgG-lambda spike and Bence Jones-lambda protein, respectively. The bone marrow was diffusely infiltrated by plasma cells. To our knowledge, this is the first reported case of a plasma cell leukemia presenting as a pancreatic mass producing extrahepatic biliary obstruction.
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Affiliation(s)
- A Malpica
- Department of Pathology, Baylor College of Medicine, Houston, TX 77030
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43
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Koizumi T, Chino M, Amari T, Kanbayashi T, Ichiyoshi T, Nakamura M, Ishida F, Saito H. [Primary plasma cell leukemia associated with hypercalcemia]. Rinsho Ketsueki 1991; 32:879-83. [PMID: 1942529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A 34-year-old male was admitted to our hospital because of anorexia and nausea in September, 1987. On admission, anemia, thrombocytopenia and hypercalcemia were observed, and the peripheral blood showed leukocytosis with atypical plasma cells (50%). Bone marrow aspiration showed hypercellularity, with a presence of atypical plasma cells (82%). The M-type protein in the serum and urine was identified as lambda Bence Jones protein by immunoelectrophoresis. On systemic skeletal X-rays, osteolytic lesions were not detected. Thus, a diagnosis of plasma cell leukemia associated with hypercalcemia was made. Hypercalcemia was treated successfully with overhydration. However the disease was refractory to combination chemotherapy, and at 10 months after diagnosis, he died of septic candidiasis. Hypercalcemia associated with plasma cell leukemia in its initial stage is rare.
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Affiliation(s)
- T Koizumi
- First Department of Internal Medicine, Shinshu University School of Medicine
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44
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Sakai A, Kawano M, Oguma N, Kuramoto A. A case of plasma cell leukemia superimposed on Philadelphia (Ph) chromosome-positive chronic myelogenous leukemia. Am J Hematol 1991; 36:222-3. [PMID: 1996563 DOI: 10.1002/ajh.2830360317] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
MESH Headings
- Blotting, Southern
- Female
- Gene Rearrangement, B-Lymphocyte
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/complications
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Plasma Cell/complications
- Leukemia, Plasma Cell/diagnosis
- Leukemia, Plasma Cell/genetics
- Middle Aged
- Plasma Cells/metabolism
- Plasma Cells/pathology
- Plasma Cells/ultrastructure
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45
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Abstract
A 56-year-old man had dyspnea, weight loss, hemoptysis, and a generalized bleeding diathesis. Physical examination disclosed hepatosplenomegaly, congestive heart failure, and multiple sites of bleeding. Severe anemia, thrombocytopenia, rouleaux formation, and a leukocytosis with circulating immature plasma cells were observed, along with azotemia, hyperuricemia, and marked elevation of total proteins with a monoclonal IgG kappa spike. The finding of increased serum viscosity confirmed the clinical impression of the hyperviscosity syndrome. Emergency plasma exchange produced marked improvement in the clinical manifestations of hyperviscosity syndrome. Systemic chemotherapy resulted in a partial remission of the disease, but the patient ultimately died of complications of treatment. In this review, we discuss the diagnosis and management of the hyperviscosity syndrome.
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Affiliation(s)
- J M Geraci
- Department of Medicine, Medical College of Wisconsin, Milwaukee
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46
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Bellan LD, Cox TA, Gascoyne RD. Parasellar syndrome caused by plasma cell leukemia. Can J Ophthalmol 1989; 24:331-4. [PMID: 2624915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A 71-year-old man had incomplete third cranial nerve palsy caused by plasma cell leukemia and a parasellar plasmacytoma. This is the first reported case of plasma cell leukemia in which a central nervous system sign was the initial manifestation. Only one previous case of intracranial plasmacytoma associated with plasma cell leukemia has been reported. The characteristics of intracranial plasmacytomas and of plasma cell leukemia are discussed.
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Affiliation(s)
- L D Bellan
- Department of Ophthalmology, University of British Columbia, Vancouver
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47
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López Guillermo A, Martí JM, Bladé J, Nomdedeu B, Montserrat E, Rozman C. [Plasma cell leukemia. Study of 10 cases]. Sangre (Barc) 1989; 34:28-31. [PMID: 2652343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Ten patients with plasma cell leukaemia (PCL), out of 259 cases of multiple myeloma diagnosed in the Haematology Service of the University Hospital of Barcelona in the last 18 years, are presented. Of the 10 PCL cases, 5 were primary and 5 were secondary. Anaemia and thrombocytopenia, along with massive plasma cell infiltration of the bone marrow, were the most striking findings. Osteolytic lesions were present in 9 of the cases and liver involvement in two. Chemotherapy including vincristine and prednisone was administered to eight patients, associated to alkylating agents (melphalan and/or cyclophosphamide) in six of them. Four of these patients received also adriamycin and BCNU. Two objective responses were achieved, lasting for 10 and 3 months, the remaining six patients failed to respond. The median survival for all the PCL patients was less than one month (ranging between 0.2 and 14 months). None of the secondary PCL patients survived for 2 months after diagnosis. Infection (3 cases of septicaemia and 3 of pneumonia), renal failure (2 cases) and liver insufficiency (1 case) were the causes of death in the nine deceased patients. The therapeutic possibilities for this severe haemopathy are discussed.
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48
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Chugh SN, Girdhar NK, Chopra JS, Singh U, Mahajan SK, Malhotra KC. Multiple myeloma with two rate complications. J Indian Med Assoc 1988; 86:246-8. [PMID: 3235845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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49
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Abstract
Primary IgA plasma cell leukemia is a rare disorder in which hyperviscosity has not been reported. We studied a patient with plasma cell leukemia and IgA lambda monoclonal gammopathy with an elevated relative serum viscosity and congestive heart failure. Plasmapheresis and chemotherapy were successful in controlling symptoms. We discuss this unusual association and review the literature.
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Affiliation(s)
- M A Kosmo
- Department of Medicine, UCLA School of Medicine 90024
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50
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Pasqualetti P, Casale R, Colantonio D, Natali G. [Contemporaneous presentation of plasma cell leukemia and multiple myeloma. Description of a clinical case with a biclonal component]. Minerva Med 1987; 78:907-10. [PMID: 3601136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
A case of simultaneous evidence of plasma cell leukaemia and multiple myeloma is reported. Plasma cell leukaemia doesn't represent an evolution of multiple myeloma, but a primitive disease, because the two forms of plasma cell dyscrasia arose from two different neoplastic plasma cell populations. In fact, leukaemic plasma cell produced IgA and were PAS-positive, while myelomatous plasma cells produced IgG and were PAS-negative. From this case, some hypothesis on simultaneous development of the two types of plasma cell neoplasias are discussed.
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