Jain Akriti G, Faisal-Uddin Mohammed, Khan Abdul K, Wazir Mohammed, Shen Qi, Manoucheri Manoucher
Internal Medicine, Florida Hospital, Orlando, FL 32804, United States.
Deccan College of Medical Sciences, Hyderabad, Telangana 500058, India.
World J Clin Oncol. 2019 Mar 24;10(3):161-165. doi: 10.5306/wjco.v10.i3.161.
Plasma cell leukemia (PCL) is diagnosed by the presence of an absolute plasma cell count of > 2 × 10/L or 20% plasma cells in the peripheral blood. Because the incidence of PCL is relatively low, our case report study presents a rare opportunity to describe the clinical and pathological characteristics of this leukemia, as well as different modalities of treatment and outcomes of primary PCL (pPCL).
A 56-year-old male with a history of hypertension complained of pain in the left flank area which started four months prior to admission. On admission, his vital signs were stable, and physical examination was completely benign. Laboratory evaluation showed hemoglobin of 5.1 g/dL, white blood cell count of 6.6 cells per cubic millimeter with 16% atypical lymphocytes, and platelet count of 51000 per microliter. Peripheral smear showed more than 10%-15% of plasma cells (Figure 1), and flow cytometry of peripheral blood confirmed PCL with 24% plasma cells CD138+. Bone marrow biopsy demonstrated 80% plasma cells (38+, 138+, 117+, 10-, 19-, 20-, 56-) with 90% cellularity. The Oncology team was consulted, and VCD therapy was started. After completing therapy at 1, 4, 8, and 11 d, the patient was discharged home. The patient was being considered for a bone marrow transplant evaluation within two months of discharge.
PCL is a rare and aggressive form of leukemia with a poor prognosis. Multi-center studies and clinical trials should be conducted to develop accurate criteria for the initial diagnosis and prompt treatment of this disease.
浆细胞白血病（PCL）的诊断依据是外周血中绝对浆细胞计数>2×10⁹/L或浆细胞占20%。由于PCL的发病率相对较低，我们的病例报告研究提供了一个难得的机会来描述这种白血病的临床和病理特征，以及原发性PCL（pPCL）的不同治疗方式和结局。
一名56岁男性，有高血压病史，主诉入院前四个月开始出现左胁腹疼痛。入院时，他的生命体征稳定，体格检查完全正常。实验室检查显示血红蛋白为5.1 g/dL，白细胞计数为每立方毫米6.6个细胞，其中16%为非典型淋巴细胞，血小板计数为每微升51000。外周血涂片显示浆细胞超过10%-15%（图1），外周血流式细胞术证实为PCL，24%的浆细胞CD138阳性。骨髓活检显示80%为浆细胞（CD38阳性、CD138阳性、CD117阳性、CD10阴性、CD19阴性、CD20阴性、CD56阴性），细胞含量为90%。咨询了肿瘤学团队后，开始了VCD治疗。在第1、4、8和11天完成治疗后，患者出院回家。出院后两个月内，该患者正在考虑进行骨髓移植评估。
PCL是一种罕见且侵袭性强的白血病，预后较差。应开展多中心研究和临床试验，以制定准确的初始诊断标准和及时治疗该疾病的方法。
