Clinical findings and immunophenotypic profile of plasma cell leukemia: a retrospective study in a comprehensive cancer center in Turkey

Plasma cell leukemia (PCL) is a rare (1-2 %) aggressive plasma cell dyscrasia (PCD) with a poor prognosis and characterized by the presence of more than 20% circulating plasma cells (PCs). Multicolor Flowcytometry is used for differentiating PCs in PCL. In this study, we aimed to compare the clinical, laboratory findings and immunophenotypic profiles of patients with PCL. A total of 512 patients were investigated for PCD in our hospital between 2011-2019. The immunophenotypic profile (including, CD27, CD28, CD38, CD138, CD45, CD117, CD19, CD20, CD56, CD33, CD81, and ckappa /clambda,) were evaluated retrospectively. The clinical findings, pathology reports, immunofixation electrophoresis and MFC results of three patients with PCL were reevaluated using 6 color multiparametric flow cytometry (MFC). Only three patients were diagnosed as PCL. PCs population defined by the co-expression of CD38 and CD138 was observed as 50%, 53%, 60%, respectively. Expression of each CD56, CD117, CD20, CD45 was seen in individual cases. CD19 was negative in all cases. Cytoplasmic kappa light chain expression was detected only in one case. Two of the cases were primary and the other was secondary PCL. Bortezomib-based treatment was initiated. Overall survival of primary PCL cases were 24 months and 6 months, whereas secondary PCL was four months. Co-expression of CD38 and CD138 in identifying PCs with MFC may be considered the best combination and leads to early diagnosis within hours and appropriate treatment in patients with PCL. [Med-Science 2021; 10(2.000): 455-61

OUTCOME OF ALLOGENEIC STEM CELL TRANSPLANTATION WITH ACTIVE DISEASE IN ACUTE MYELOID LEUKEMIA

Introduction: Despite multiple lines of chemotherapy, some patients with acute myeloid leukemia (AML) can not achieve remission. The prognosis of these patients is quite poor and they should be evaluated for clinical trials, otherwise myeloablative conditioning regimens followed by allogeneic stem cell transplantation (Allo-SCT) should be performed to over come the active disease which is resistant to conventional doses and as it is the only curative option. Method: In this study, we evaluated the outcome of AML patients who underwent Allo-SCT with active disease in our center retrospectively. Results: A total of 161 AML patients underwent Allo-SCT between December 2009 and November 2018 at our center. 130 of them underwent Allo-SCT in complete remission while 31 of 161 had to undergo Allo-SCT with active disease due to refractoriness to salvage therapies. The median overall survival (OS) was7.9±2.8 months. 6-month OS was 25% and 1-year OS was only 6%. Progression-free survival (PFS) was 3.53±1.1 months. The transplant-related mortality rate was12.8%. Conclusion: OS and PFS are short in patients who undergo Allo-SCT with active diseases on oveltreatment approaches and targeted therapies should be developed to overcome active disease that are refractory to conventional chemotherapies