Famularo Giuseppe, Armentano Cinzia, Mechelli Andrea, De Laurenzi Antonio, Nicotra Giulio Cesare
Dipartimento di Medicina Interna e Specialistica, Azienda Ospedaliera San Camillo-Forlanini, Roma.
Recenti Prog Med. 2003 Feb;94(2):66-8.
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.
原发性浆细胞白血病是恶性单克隆丙种球蛋白病的一种罕见变异型,在白血病期呈原发表现。文献中仅报道了少数纳入超过20例患者的系列研究。作者报道了1例原发性浆细胞白血病暴发性表现且预后不良的患者。原发性浆细胞白血病的诊断依据凯尔标准确立,该标准包括绝对浆细胞计数大于2×10⁹/L或相对浆细胞数占外周血细胞的比例大于20%。该患者在诊断后三天内死于肺炎链球菌败血症休克和多器官功能衰竭。由于原发性浆细胞白血病的罕见性,以及恶性丙种球蛋白病患者中暴发性表现并不常见,该病例报告值得关注。