a Hematology Department , Jagiellonian University Medical College , Cracow , Poland.
b Dana-Farber Cancer Institute , Harvard Medical School , Boston , MA , USA.
Leuk Lymphoma. 2019 Jan;60(1):118-123. doi: 10.1080/10428194.2018.1473574. Epub 2018 Jul 2.
This multicenter retrospective study included 101 patients (median age 62 years) with secondary plasma cell leukemia (sPCL). The median time from initial multiple myeloma diagnosis to sPCL was 31 months. Fifty-five out of 72 patients (75%) who received any therapy were treated with immunomodulators (IMiDs) and/or proteasome inhibitors (PIs), and 14/72 (19%) underwent salvage autologous stem cell transplantation (ASCT). The overall response rate in patients who received ASCT or PI (either alone or in combination) was higher than in those who did not (93% vs. 36% and 60% vs. 30%, respectively). The median overall survival (OS) in patients who received therapy was 4.2 months (95% CI: 1.3; 8.0) with a 1-year OS of 19%. Platelet count ≤100 × 10/L at sPCL diagnosis was the only independent predictor of a poorer OS in treated patients (HR = 3.98, p = .0001). These findings suggest that patients with sPCL may benefit from salvage ASCT- and PI-based regimens.
这项多中心回顾性研究纳入了 101 例继发浆细胞白血病（sPCL）患者（中位年龄 62 岁）。从初始多发性骨髓瘤诊断到 sPCL 的中位时间为 31 个月。在接受任何治疗的 72 例患者中，有 55 例（75%）接受了免疫调节剂（IMiDs）和/或蛋白酶体抑制剂（PIs）治疗，14 例（19%）接受了挽救性自体干细胞移植（ASCT）。接受 ASCT 或 PI（单独或联合）治疗的患者的总体缓解率高于未接受治疗的患者（分别为 93% vs. 36%和 60% vs. 30%）。接受治疗的患者的中位总生存期（OS）为 4.2 个月（95%CI：1.3；8.0），1 年 OS 率为 19%。在接受治疗的患者中，sPCL 诊断时血小板计数≤100×10/L 是 OS 较差的唯一独立预测因素（HR=3.98，p=0.0001）。这些发现表明，sPCL 患者可能受益于挽救性 ASCT 和基于 PI 的治疗方案。
