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Ge X, Meng W, Wang W, Ma H, Zhao S, Cui K. Causes of death in primary plasma cell leukemia differ from multiple myeloma: A STROBE-compliant descriptive study based on SEER database. Medicine (Baltimore) 2022; 101:e29578. [PMID: 35866755 PMCID: PMC9302293 DOI: 10.1097/md.0000000000029578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The primary plasma cell leukemia (pPCL) is a rare but aggressive variant of multiple myeloma (MM). Few studies have focused on the differences in the causes of death between pPCL and MM. This study aimed to compare and evaluate the causes of death of patients with pPCL and MM. The data were collected from the Surveillance Epidemiology, and End Results (SEER) database. The demographic characteristics, survival, and causes of death in pPCL and MM patients were evaluated and compared. The competing risk regression model was performed to predict the cause of death. Between 1975 and 2009, the overall mortality rate was 96.13% and 88.71% for pPCL and MM, and the median survival was 9 and 26 months, respectively. In pPCL, leukemia caused 45.05% of the deaths, followed by myeloma (38.83%). In MM, myeloma was the leading cause of death, accounting for 74.89% of the deaths. Older age at diagnosis was a risk factor for dying of leukemia in pPCL patients (HR = 1.49, 95% CI: 1.16-1.91), while older age at death was associated with reduced risk (HR = 0.67, 95% CI: 0.52-0.86). Although the survival of pPCL patients increased with time periods of diagnosis since 1975 to 2009, the risk of dying of leukemia increased with the periods. For MM, most of the demographic characteristics were found to have independently predicting influence on the cause of death. Patients with pPCL and MM had distinct causes of death. Leukemia was the leading and the most serious cause of death in pPCL patients. The demographic factors could not predict the causes of death in pPCL. More large-scale and multi-center studies are needed to evaluate the effect of novel agents in pPCL patients, especially for patients who have progressed to leukemia.
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Affiliation(s)
- Xiaoyan Ge
- Department of Health Statistics, School of Public Health, Jinzhou Medical University, Jinzhou, Liaoning Province, P.R. China
| | - Weihan Meng
- Department of Health Statistics, School of Public Health, Jinzhou Medical University, Jinzhou, Liaoning Province, P.R. China
| | - Wenbo Wang
- Department of Health Statistics, School of Public Health, Jinzhou Medical University, Jinzhou, Liaoning Province, P.R. China
| | - Honglin Ma
- Department of Health Statistics, School of Public Health, Jinzhou Medical University, Jinzhou, Liaoning Province, P.R. China
| | - Siqi Zhao
- Department of Health Statistics, School of Public Health, Jinzhou Medical University, Jinzhou, Liaoning Province, P.R. China
| | - Kai Cui
- Department of Health Statistics, School of Public Health, Jinzhou Medical University, Jinzhou, Liaoning Province, P.R. China
- *Correspondence: Kai Cui, Department of Health Statistics, School of Public Health, Jinzhou Medical University, 40 Songpo Road, Jinzhou 121000, P.R. China (e-mail: )
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[Update on biology of primary plasma cell leukemia]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2022; 43:603-607. [PMID: 36709141 PMCID: PMC9395563 DOI: 10.3760/cma.j.issn.0253-2727.2022.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Gowin K, Skerget S, Keats JJ, Mikhael J, Cowan AJ. Plasma cell leukemia: A review of the molecular classification, diagnosis, and evidenced-based treatment. Leuk Res 2021; 111:106687. [PMID: 34425325 DOI: 10.1016/j.leukres.2021.106687] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/22/2021] [Accepted: 08/15/2021] [Indexed: 12/11/2022]
Abstract
Plasma cell leukemia is a rare and aggressive plasma cell dyscrasia associated with dismal outcomes. It may arise de novo, primary plasma cell leukemia, or evolve from an antecedent diagnosis of multiple myeloma, secondary plasma cell leukemia. Despite highly effective therapeutics, survival for plasma cell leukemia patients remains poor. Molecular knowledge of plasma cell leukemia has recently expanded with use of gene expression profiling and whole exome sequencing, lending new insights into prognosis and therapeutic development. In this review, we describe the molecular knowledge, clinical characteristics, evidenced-based therapeutic approaches and treatment outcomes of plasma cell leukemia.
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Affiliation(s)
- Krisstina Gowin
- University of Arizona, Department of Bone Marrow Transplant and Cellular Therapy, Tucson, AZ, United States.
| | - Sheri Skerget
- Translational Genomics Research Institute (TGen), Integrated Cancer Genomics Division, Phoenix, AZ, United States
| | - Jonathan J Keats
- Translational Genomics Research Institute (TGen), Integrated Cancer Genomics Division, Phoenix, AZ, United States
| | - Joseph Mikhael
- Translational Genomics Research Institute (TGen), Applied Cancer Research and Drug Discovery Division, Phoenix, AZ, United States
| | - Andrew J Cowan
- University of Washington, Department of Hematology Oncology, Seattle, WA, United States
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Visram A, Suska A, Jurczyszyn A, Gonsalves WI. Practical management and assessment of primary plasma cell leukemia in the novel agent era. Cancer Treat Res Commun 2021; 28:100414. [PMID: 34174530 DOI: 10.1016/j.ctarc.2021.100414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/08/2021] [Accepted: 05/27/2021] [Indexed: 10/21/2022]
Affiliation(s)
- A Visram
- University of Ottawa, Ottawa Hospital Research Institute, Ottawa, ON, Canada; Division of Hematology, Mayo Clinic, Rochester, MN, United States
| | - A Suska
- Department of Hematology, Jagiellonian University Medical College, Kopernika 17, Krakow 31-501, Poland
| | - A Jurczyszyn
- Department of Hematology, Jagiellonian University Medical College, Kopernika 17, Krakow 31-501, Poland
| | - W I Gonsalves
- Division of Hematology, Mayo Clinic, Rochester, MN, United States.
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Xu L, Liu Y, Lai XF, Bai Y, Feng JN, Zhan SY, Huang XJ, Wang SF, Lu J. [Prevalence investigation of plasma cell leukemia in China: a calculation based on national urban medical insurance in 2016]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2021; 41:984-988. [PMID: 33445844 PMCID: PMC7840543 DOI: 10.3760/cma.j.issn.0253-2727.2020.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
目的 分析我国城市人口中浆细胞白血病(PCL)的流行病学特征,并测算2016年PCL患病率。 方法 利用我国23个省2016年1月1日至2016年12月31日的城镇基本医疗保险数据进行测算。利用医疗保险数据中的疾病诊断名称和疾病诊断编码识别PCL患者。按性别、地区和年龄进行亚组分析,并通过敏感性分析考察结果的稳健性。基于我国2010年全国人口普查数据计算按年龄调整的标准化患病率。 结果 2016年我国城市人口中PCL患病率为0.11/10万(95%CI 0.05~0.19),其中男性和女性患病率分别为0.12/10万(95%CI 0.06~0.21),0.10/10万(95%CI 0.04~0.19)。PCL的患病率在70~79岁时达高峰。敏感性分析显示本研究结果具有稳健性。根据我国2010年全国人口普查数据所得的标化患病率为0.12/10万(95%CI 0.11~0.13)。 结论 本研究首次利用全国城镇医疗保险数据测算我国PCL的患病率,为PCL相关研究和政策制定提供依据。
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Affiliation(s)
- L Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Y Liu
- Peking University Institute of Hematology, Peking University People's Hospital, National Clinical Research, Center for Hematologic Disease, Beijing 100044, China
| | - X F Lai
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Y Bai
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - J N Feng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - S Y Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China
| | - X J Huang
- Peking University Institute of Hematology, Peking University People's Hospital, National Clinical Research, Center for Hematologic Disease, Beijing 100044, China; Innovative Center of Hematology, Soochow University, Suzhou 215123, China
| | - S F Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - J Lu
- Peking University Institute of Hematology, Peking University People's Hospital, National Clinical Research, Center for Hematologic Disease, Beijing 100044, China; Innovative Center of Hematology, Soochow University, Suzhou 215123, China
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Suska A, Vesole DH, Castillo JJ, Kumar SK, Parameswaran H, Mateos MV, Facon T, Gozzetti A, Mikala G, Szostek M, Mikhael J, Hajek R, Terpos E, Jurczyszyn A. Plasma Cell Leukemia - Facts and Controversies: More Questions than Answers? Clin Hematol Int 2020; 2:133-142. [PMID: 34595454 PMCID: PMC8432408 DOI: 10.2991/chi.k.200706.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/01/2020] [Indexed: 11/18/2022] Open
Abstract
Plasma cell leukemia (PCL) is an aggressive hematological malignancy characterized by an uncontrolled clonal proliferation of plasma cells (PCs) in the bone marrow and peripheral blood. PCL has been defined by an absolute number of circulating PCs exceeding 2.0 × 109/L and/or >20% PCs in the total leucocyte count. It is classified as primary PCL, which develops de novo, and secondary PCL, occurring at the late and advanced stages of multiple myeloma (MM). Primary and secondary PCL are clinically and biologically two distinct entities. After the diagnosis, treatment should be immediate and should include a proteasome inhibitor and immunomodulator-based combination regimens as induction, followed by stem cell transplantation (SCT) in transplant-eligible individuals who have cleared the peripheral blood of circulating PCs. Due to the rarity of the condition, there have been very few clinical trials. Furthermore, virtually all of the myeloma trials exclude patients with active PCL. The evaluation of response has been defined by the International Myeloma Working Group and consists of both acute leukemia and MM criteria. With conventional chemotherapy, the prognosis of primary PCL has been ominous, with reported overall survival (OS) ranging from 6.8 to 12.6 months. The use of novel agents and autologous SCT appears to be associated with deeper response and an improved survival, although it still remains low. The PCL prognostic index provides a simple score to risk-stratify PCL. The prognosis of secondary PCL is extremely poor, with OS of only 1 month.
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Affiliation(s)
- Anna Suska
- Department of Hematology, Jagiellonian University Medical College, Kopernika 17, Krakow 31-501, Poland
| | - David H Vesole
- The John Theurer Cancer Center at Hackensack UMC, Hackensack, NJ, USA
| | - Jorge J Castillo
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Shaji K Kumar
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | - Maria V Mateos
- Complejo Asistencial Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (CAUSA/IBSAL), Salamanca, Spain
| | - Thierry Facon
- Service des Maladies du Sang, Hôpital Claude Huriez, Lille, France
| | | | - Gabor Mikala
- Department of Hematology and Stem Cell Transplantation, South-Pest Central Hospital, Natl. Inst. Hematol. Infectol, Budapest, Hungary
| | - Marta Szostek
- Department of Hematology, Jagiellonian University Medical College, Kopernika 17, Krakow 31-501, Poland
| | - Joseph Mikhael
- Translational Genomics Research Institute, City of Hope Cancer Center, Phoenix, Arizona, USA
| | - Roman Hajek
- University Hospital Ostrava and Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Evangelos Terpos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Artur Jurczyszyn
- Department of Hematology, Jagiellonian University Medical College, Kopernika 17, Krakow 31-501, Poland
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7
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Extramedullary multiple myeloma. Leukemia 2019; 34:1-20. [DOI: 10.1038/s41375-019-0660-0] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 07/31/2019] [Accepted: 08/12/2019] [Indexed: 01/07/2023]
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8
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Musto P, Statuto T, Valvano L, Grieco V, Nozza F, Vona G, Bochicchio GB, La Rocca F, D'Auria F. An update on biology, diagnosis and treatment of primary plasma cell leukemia. Expert Rev Hematol 2019; 12:245-253. [PMID: 30905220 DOI: 10.1080/17474086.2019.1598258] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Primary plasma cell leukemia (PPCL) is one of the most aggressive hematological malignancies. The prognosis of PPCL patients remains poor, although some improvements have been made in recent years. Areas covered: In this review recent clinical and biological advances in PPCL are reported. Some recommendations for the practical management of these patients are provided, with a particular focus on the role of novel agents and transplant procedures. A brief description of the currently ongoing clinical trials with new drugs is also enclosed. Expert opinion: PPCL still represents a difficult challenge for all hematologists. Here the authors provide a personal view on how the current, generally unsatisfactory results in this neoplastic disorder could be improved. In particular, dedicated studies exploring alternative therapies are necessary and eagerly awaited. Such studies should possibly be based on new biological information that could be of help in identifying novel genetic biomarkers for risk stratification and new actionable molecular targets.
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Affiliation(s)
- Pellegrino Musto
- a Unit of Hematology and Stem Cell Transplantation , IRCCS-CROB, Referral Cancer Center of Basilicata , Rionero in Vulture (Pz) , Italy.,b Department of Hematology of Basilicata , IRCCS-CROB, Referral Cancer Center of Basilicata , Rionero in Vulture (Pz) , Italy.,c Scientific Direction, Laboratory of Clinical Research and Advanced Diagnostics , IRCCS-CROB, Referral Cancer Center of Basilicata , Rionero in Vulture (Pz) , Italy
| | - Teodora Statuto
- c Scientific Direction, Laboratory of Clinical Research and Advanced Diagnostics , IRCCS-CROB, Referral Cancer Center of Basilicata , Rionero in Vulture (Pz) , Italy
| | - Luciana Valvano
- c Scientific Direction, Laboratory of Clinical Research and Advanced Diagnostics , IRCCS-CROB, Referral Cancer Center of Basilicata , Rionero in Vulture (Pz) , Italy
| | - Vitina Grieco
- c Scientific Direction, Laboratory of Clinical Research and Advanced Diagnostics , IRCCS-CROB, Referral Cancer Center of Basilicata , Rionero in Vulture (Pz) , Italy
| | - Filomena Nozza
- c Scientific Direction, Laboratory of Clinical Research and Advanced Diagnostics , IRCCS-CROB, Referral Cancer Center of Basilicata , Rionero in Vulture (Pz) , Italy
| | - Gabriella Vona
- c Scientific Direction, Laboratory of Clinical Research and Advanced Diagnostics , IRCCS-CROB, Referral Cancer Center of Basilicata , Rionero in Vulture (Pz) , Italy
| | | | - Francesco La Rocca
- c Scientific Direction, Laboratory of Clinical Research and Advanced Diagnostics , IRCCS-CROB, Referral Cancer Center of Basilicata , Rionero in Vulture (Pz) , Italy
| | - Fiorella D'Auria
- c Scientific Direction, Laboratory of Clinical Research and Advanced Diagnostics , IRCCS-CROB, Referral Cancer Center of Basilicata , Rionero in Vulture (Pz) , Italy
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Abstract
Purpose of Review We discuss current topics on the definition of plasma cell leukemia and the distinction between plasma cell leukemia and multiple myeloma. Moreover, we review the latest literature on how to treat plasma cell leukemia. Recent Findings Plasma cell leukemia is clinically and genetically distinct from multiple myeloma. Plasma cell leukemia is defined by the observation in blood of more than 20% clonal plasma cells by differential count of the leucocytes or by counting more than 2 × 109 per liter circulating clonal plasma cells. However, patients with lower levels of circulating plasma cells have the same adverse prognosis, which challenges the disease definition. Survival has improved after implementation of high-dose chemotherapy with stem-cell support, bortezomib, and lenalidomide in the treatment; yet, the prognosis remains poor. The results of allo-transplants have been disappointing. Summary The diagnostic criteria of PCL are currently discussed in the international myeloma community. Despite some improvement in survival, the prognosis remains adverse. New, more targeted treatment modalities, including immunotherapies, will hopefully improve the outcome in the near future.
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Affiliation(s)
- Michael Tveden Gundesen
- Department of Hematology, Odense University Hospital, Kloevervaenget 10, 12th floor, DK-5000, Odense C, Denmark
| | - Thomas Lund
- Department of Hematology, Odense University Hospital, Kloevervaenget 10, 12th floor, DK-5000, Odense C, Denmark
| | - Hanne E H Moeller
- Department of Pathology, Odense University Hospital, JP Winsløvs vej 15, 2th floor, DK-5000, Odense C, Denmark
| | - Niels Abildgaard
- Department of Hematology, Odense University Hospital, Kloevervaenget 10, 12th floor, DK-5000, Odense C, Denmark. .,Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
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10
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Nakaya A, Yagi H, Kaneko H, Kosugi S, Kida T, Adachi Y, Shibayama H, Kohara T, Kamitsuji Y, Fuchida SI, Uoshima N, Kawata E, Uchiyama H, Shimura Y, Takahashi T, Urase F, Ohta K, Hamada T, Miyamoto K, Kobayashi M, Shindo M, Tanaka H, Shimazaki C, Hino M, Kuroda J, Kanakura Y, Takaoari-Kondo A, Nomura S, Matsumura I. Retrospective analysis of primary plasma cell leukemia in Kansai Myeloma Forum registry. Leuk Res Rep 2018; 10:7-10. [PMID: 30013912 PMCID: PMC6043871 DOI: 10.1016/j.lrr.2018.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/12/2018] [Accepted: 07/02/2018] [Indexed: 11/20/2022] Open
Abstract
The prevalence of pPCL was 1.2%. Treatment with novel agents and transplantation may yield a better prognosis. Hypercalcemia at diagnosis was suggested to predict worse outcomes.
We retrospectively analyzed twenty-six patients with primary plasma cell leukemia (pPCL) registered from May 2005 until April 2015 by the Kansai Myeloma Forum. Twenty patients received novel agents (bortezomib or lenalidomide), and their median survival of was 34 months. The median survival of patients who underwent autologous stem cell transplantation (SCT) was 40 months, those undergoing allogeneic SCT 55 months, and those undergoing both types of SCT (auto–allo) 61 months; whereas for those who did not undergo SCT it was 28 months (p = 0.845). The only statistically significant risk factor identified by multivariate analysis was hypercalcemia.
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Affiliation(s)
- Aya Nakaya
- First Department of Internal Medicine, Kansai Medical University, Japan
- Kansai Myeloma Forum, Japan
- Corresponding author at: First Department of Internal Medicine, Kansai Medical University, 10-15 Fumizono-cho, Moriguchi-City, Osaka 570-8507, Japan.
| | - Hideo Yagi
- Department of Hematology, Nara Hospital, Kindai University School of Medicine, Japan
- Kansai Myeloma Forum, Japan
| | - Hitomi Kaneko
- Japanese Red Cross Osaka Hospital, Department of Hematology, Japan
- Kansai Myeloma Forum, Japan
| | - Satoru Kosugi
- Department of Internal Medicine (Hematology), Toyonaka Municipal Hospital, Japan
- Kansai Myeloma Forum, Japan
| | - Toru Kida
- Department of Internal Medicine (Hematology), Toyonaka Municipal Hospital, Japan
- Kansai Myeloma Forum, Japan
| | - Yoko Adachi
- JCHO Kobe Central Hospital, Department of Internal Medicine, Japan
- Kansai Myeloma Forum, Japan
| | - Hirohiko Shibayama
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Japan
- Kansai Myeloma Forum, Japan
| | - Takae Kohara
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Japan
- Kansai Myeloma Forum, Japan
| | - Yuri Kamitsuji
- Department of Hematology, Matsushita Memorial Hospital, Japan
- Kansai Myeloma Forum, Japan
| | - Shin-ichi Fuchida
- Japan Community Health care Organization Kyoto Kuramaguchi Medical Center, Department of Hematology, Japan
- Kansai Myeloma Forum, Japan
| | - Nobuhiko Uoshima
- Japanese Red Cross Kyoto Daini Hospital, Department of Hematology, Japan
- Kansai Myeloma Forum, Japan
| | - Eri Kawata
- Japanese Red Cross Kyoto Daini Hospital, Department of Hematology, Japan
- Kansai Myeloma Forum, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Yuzuru Kanakura
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Japan
- Kansai Myeloma Forum, Japan
| | | | - Shosaku Nomura
- First Department of Internal Medicine, Kansai Medical University, Japan
- Kansai Myeloma Forum, Japan
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Ganzel C, Rouvio O, Avivi I, Magen H, Jarchowsky O, Herzog K, Cohen Y, Tadmor T, Horwitz NA, Leiba M, Nagler A, Cohen Y, Bulvik S, Polliack A, Rowe JM, Gatt ME. Primary plasma cell leukemia in the era of novel agents for myeloma – a multicenter retrospective analysis of outcome. Leuk Res 2018; 68:9-14. [DOI: 10.1016/j.leukres.2018.02.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 01/28/2018] [Accepted: 02/13/2018] [Indexed: 02/07/2023]
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Real-world data on prognosis and outcome of primary plasma cell leukemia in the era of novel agents: a multicenter national study by the Greek Myeloma Study Group. Blood Cancer J 2018. [PMID: 29523783 PMCID: PMC5849880 DOI: 10.1038/s41408-018-0059-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
We have studied the efficacy and the prognostic impact of novel agents in 50 primary plasma cell leukemia (pPCL) patients registered in our database. Eighty percent of patients were treated upfront with novel agent-based combinations; 40% underwent autologous stem cell transplantation (ASCT). Objective response rate was 76; 38% achieved at least very good partial response (≥vgPR) and this correlated significantly with bortezomib-based therapy plus ASCT. At the time of evaluation, 40 patients had died. Early mortality rate (≤1 month) was 6%. Median progression-free survival (PFS) and overall survival (OS) were 12 months and 18 months respectively, both significantly longer in patients treated with bortezomib-based therapy + ASCT vs. others (PFS: 18 vs. 9 months; p = 0.004, OS: 48 vs. 14 months; p = 0.007). Bortezomib-based therapy + ASCT predicted for OS in univariate analysis. In multivariate analysis, achievement of ≥vgPR and LDH ≥ 300 U/L were significant predictors for OS. These real-world data, based on one of the largest reported national multicenter series of pPCL patients treated mostly with novel agents support that, among the currently approved induction therapies, bortezomib-based regimens are highly effective and reduce the rate of early mortality whereas in combination with ASCT consolidation they prolong OS.
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13
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Jung SH, Lee JJ, Kim K, Suh C, Yoon DH, Min CK, Sohn SK, Choi CW, Lee HS, Kim HJ, Shin HJ, Bang SM, Yoon SS, Park SK, Yhim HY, Kim MK, Jo JC, Mun YC, Lee JH, Kim JS. The role of frontline autologous stem cell transplantation for primary plasma cell leukemia: a retrospective multicenter study (KMM160). Oncotarget 2017; 8:79517-79526. [PMID: 29108331 PMCID: PMC5668064 DOI: 10.18632/oncotarget.18535] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 06/05/2017] [Indexed: 12/13/2022] Open
Abstract
Primary plasma cell leukemia (pPCL) is a rare and aggressive plasma cell neoplasm, with rapidly progressing clinical course. We evaluated the treatment status and survival outcomes of 69 Korean patients with pPCL. Of them, 59 patients were treated; 15 (25.4%) were treated initially with novel agent-based regimens with upfront autologous stem cell transplantation (ASCT), 7 (11.9%) with conventional chemotherapy with upfront ASCT, 21 (35.6%) with novel agent-based regimens only, and 16 (27.1%) were treated with conventional chemotherapy alone. Overall response rates after initial therapy were significantly higher in patients treated with novel agent-based regimens compared with those treated with conventional chemotherapies (75% vs. 43.4%, P = 0.026). Median progression-free survival (PFS) and overall survival (OS) were 12.2 months and 16.1 months, respectively. The median PFS of the four treatment groups–conventional chemotherapy alone, novel agents alone, conventional chemotherapy with ASCT, and novel agents with ASCT–were 1.2, 9.0, 10.5, and 26.4 months, respectively (P < 0.001); the median OS of the four treatment groups were 2.9, 12.3, 14.1, and 31.1 months, respectively (P < 0.001). The median OS was also significantly better in the patients with novel agents with ASCT versus other patients. In a multivariate analysis, an increased lactate dehydrogenase level, low albumin (< 3.5 g/dL), and non-CR after front-line treatment were independently associated with poor PFS and OS. In conclusion, the use of novel agent-based therapy with ASCT and achieving a deep response to front-line treatment are important in expecting improved PFS and OS in patients with pPCL.
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Affiliation(s)
- Sung-Hoon Jung
- Chonnam National University Hwasun Hospital, Hwasun, Jeollanamdo, Republic of Korea
| | - Je-Jung Lee
- Chonnam National University Hwasun Hospital, Hwasun, Jeollanamdo, Republic of Korea
| | - Kihyun Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Cheolwon Suh
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Dok Hyun Yoon
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Chang-Ki Min
- Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sang Kyun Sohn
- Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Chul Won Choi
- Korea University School of Medicine, Seoul, Republic of Korea
| | - Ho Sup Lee
- Kosin University Gospel Hospital, Busan, Republic of Korea
| | - Hyo Jung Kim
- Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Ho-Jin Shin
- Pusan National University Hospital, Busan, Republic of Korea
| | - Soo-Mee Bang
- Seoul National University Bundang Hospital, Seoul, Republic of Korea
| | - Sung-Soo Yoon
- Seoul National University Hospital, Seoul, Republic of Korea
| | - Seong Kyu Park
- Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Ho-Young Yhim
- Chonbuk National University Medical School, Jeonju, Republic of Korea
| | - Min Kyoung Kim
- Yeungnam University Medical Center, Daegu, Republic of Korea
| | - Jae-Cheol Jo
- Ulsan University Hospital, Ulsan, Republic of Korea
| | - Yeung-Chul Mun
- Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Jae Hoon Lee
- Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Jin Seok Kim
- Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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14
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Weberpals J, Pulte D, Jansen L, Luttmann S, Holleczek B, Nennecke A, Ressing M, Katalinic A, Merz M, Brenner H. Survival of patients with lymphoplasmacytic lymphoma and solitary plasmacytoma in Germany and the United States of America in the early 21 st century. Haematologica 2017; 102:e229-e232. [PMID: 28280077 PMCID: PMC5451350 DOI: 10.3324/haematol.2016.157768] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Janick Weberpals
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Dianne Pulte
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Lina Jansen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sabine Luttmann
- Bremen Cancer Registry, Leibniz-Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | | | - Alice Nennecke
- Hamburg Cancer Registry, Authority for Health and Consumer Protection, Hamburg, Germany
| | - Meike Ressing
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
- Cancer Registry Rhineland-Palatinate, Mainz, Germany
| | | | - Maximilian Merz
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
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15
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Neri A, Todoerti K, Lionetti M, Simeon V, Barbieri M, Nozza F, Vona G, Pompa A, Baldini L, Musto P. Primary plasma cell leukemia 2.0: advances in biology and clinical management. Expert Rev Hematol 2016; 9:1063-1073. [DOI: 10.1080/17474086.2016.1244002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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16
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Affiliation(s)
- Pellegrino Musto
- Istituto di Ricovero e Cura a Carattere Scientifico, Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture (Pz), Italy
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17
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18
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Musto P. Novel Agents for the Treatment of Primary Plasma-Cell Leukemia: Lights and Shadows. Acta Haematol 2015; 135:110-2. [PMID: 26506015 DOI: 10.1159/000441345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 09/24/2015] [Indexed: 11/19/2022]
Affiliation(s)
- Pellegrino Musto
- IRCCS-CROB, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
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