Concurrent B-cell chronic lymphocytic leukemia and multiple myeloma treated successfully with lenalidomide

Srinivasan, Sridhar; Schiffer, Charles A.

doi:10.1016/j.leukres.2008.06.024

Cited by 14 publications

(16 citation statements)

References 30 publications

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“…But the 2 processes may arise independently from the same stem cell or arise from different B cells purely coincidentally. Interestingly, only 3 of 51 published reports, 17,44,45 and none of our cases, show PCM preceding CLL (Table 4). Putative transformation of CLL cells to plasma cells may be inferred only by showing clonal identity between the 2 processes.…”

Section: Commentmentioning

confidence: 53%

“…24 In our cohort, information for light-chain restriction of CLL and PCM cells was available for 13 cases: restriction was the same in 7 and different in 6 cases. In the published reports, excluding the 3 cases first presenting with PCM, 17,44,45 information for light-chain restriction of CLL and PCM cells was available for 28 cases and the light-chain restriction was the same in 15 cases and different in 13. A Kaplan-Meier survival analysis (data not shown) in which the published cases and our cases were divided on the basis of same or different light-chain restriction showed statistically similar disease-specific median survival rates of 22 months and 28 months, respectively.…”

Section: Commentmentioning

confidence: 99%

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Diagnostic and Clinical Considerations in Concomitant Bone Marrow Involvement by Plasma Cell Myeloma and Chronic Lymphocytic Leukemia/Monoclonal B-Cell Lymphocytosis: A Series of 15 Cases and Review of Literature

Alley

Wang

Dunphy

et al. 2013

Archives of Pathology &Amp; Laboratory Medicine

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Context.-Plasma cell myeloma and chronic lymphocytic leukemia are both common hematologic malignancies, sharing many epidemiologic features. Concomitant detection of the 2 conditions poses special diagnostic challenges for the pathologist.Objective.-To describe the pathologic findings in cases of concomitant bone marrow involvement by myeloma and CD5þ monoclonal B cells and to outline the differential diagnostic possibilities, suggest a workup for correct diagnosis, and examine clinical outcome.Design.-Fifteen cases that met the diagnostic criteria were identified from pathology databases at 4 participating institutions. Morphologic findings were reviewed, additional immunohistochemical stains performed, and flow cytometric, cytogenetic, and relevant laboratory and clinical information was summarized. Previously published cases were searched from electronic databases and cross-references.Results.-Most patients (13 of 15) were older males. Often (11 of 15) they presented clinically with myeloma, yet had both monotypic plasma cells and B cells in the diagnostic marrow. In 4 patients, myeloma developed 24 months or later after chronic lymphocytic leukemia. In 7 patients, myeloma and CD5 þ B cells showed identical immunoglobulin light-chain restriction. Primary differential diagnoses include lymphoplasmacytic lymphoma, marginal zone lymphoma, and chronic lymphocytic leukemia with plasmacytoid differentiation. CD56 and/or cyclin D1 expression by plasma cells was helpful for correct diagnosis. Most patients in our cohort and published reports were treated for plasma cell myeloma.Conclusions.-Concomitant detection of myeloma and chronic lymphocytic leukemia in the bone marrow is a rare event, which must be carefully differentiated from lymphomas with lymphoplasmacytic differentiation for correct treatment.

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Section: Commentmentioning

confidence: 53%

Section: Commentmentioning

confidence: 99%

Diagnostic and Clinical Considerations in Concomitant Bone Marrow Involvement by Plasma Cell Myeloma and Chronic Lymphocytic Leukemia/Monoclonal B-Cell Lymphocytosis: A Series of 15 Cases and Review of Literature

Alley

Wang

Dunphy

et al. 2013

Archives of Pathology &Amp; Laboratory Medicine

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“…Some case studies have provided evidence that both arise from a single clone [8,15]. On the other hand, some authors have concluded that chronic lymphocytic leukemia and multiple myeloma occurring concomitantly in a single patient arise from two separate clones [5,7,9,13]. The techniques applied by various authors include sequencing and study of heavy chain gene rearrangement in both the populations of lymphocytes and plasma cells or study of interphase FISH for clonal chromosomal abnormalities [3,6,10].…”

Section: Discussionmentioning

confidence: 99%

“…Even though chronic lymphocytic leukemia (CLL) and multiple myeloma are individually quite common, there are very few published reports of concomitant presence of CLL and multiple myeloma in the same patient [1][2][3][4][5][6]. This diagnosis has to be carefully differentiated from small B cell lymphomas showing plasma cell differentiation, splenic marginal zone lymphoma with plasmacytic differentiation and chronic lymphocytic leukemia with plasmacytic differentiation [1].…”

Section: Introductionmentioning

confidence: 99%

Concomitant Presence of Two Distinct Clones of Chronic Lymphocytic Leukemia and Plasma Cell Myeloma in a Patient

Langer¹,

Mehta²,

Saraf³

et al. 2015

Indian J Hematol Blood Transfus

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A 74 years old male patient, presented with history of generalized weakness, fatigue, loss of appetite and breathlessness on exertion for past one and a half months. On examination, he was found to have significant pallor and generalized lymphadenopathy (cervical, axillary and inguinal). The skeletal survey showed punched out lytic lesions in skull and pelvic bones. The peripheral smear examination showed lymphocytosis with absolute lymphocyte count of 25,000/μL. The bone marrow aspirates revealed a hypercellular marrow with 74 % lymphocytes & 14 % plasma cells, suggestive of chronic lymphoplasmacytic disorder. The bone marrow biopsy had two morphologically distinct populations of lymphocytes & plasma cells. The immunohistochemical markers on bone marrow biopsy showed hat plasma cells were positive for CD138 with kappa light chain restriction. Flow cytometry showed B cell population with CD19/CD5 co expression, CD5/CD23 coexpression, were positive for CD22, CD20 and negative for FMC-7 and lambda light chain. In addition, plasma cells were also identified as CD45 negative cells and showed CD38/CD138 co-expression with variable CD19 and CD56 positivity. Serum protein electrophoresis revealed M band, serum immunofixation electrophoresis corresponded to IgA -Kappa. The final diagnosis of chronic lymphocytic leukemia with concomittant presence of plasma cell myeloma was concluded. This case imparts an important message to look for presence of coexisting entities in a single specimen and highlights the benefits of testing both plasma cell and B-cell compartments when the clinical features are not entirely consistent Flow cytometry together with protein electrophoresis can help to clinch difficult and rare dual diagnosis. These cases are rare and pose therapeutic challenge.

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“…PCM, because of its higher prevalence, has been described to be concomitant with or subsequent to other lymphoid neoplasms [3][4][5][6][7][8][9], mostly chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) [3][4][5][6][7][8], but sequential development of WM and PCM or their coexistence in the bone marrow of the same individual is extremely rare and has not been reported in the English literature. Here, we report the first case of sequential development of WM and PCM over a 10-year-period in a 73-year-old male patient with an untreated IgM paraproteinemia.…”

Section: Introductionmentioning

confidence: 99%

Concomitant Waldenstrom macroglobulinemia and IgA plasmablastic myeloma in a patient with untreated IgM paraproteinemia: sequential development of biclonal B-cell neoplasms over a 10-year period in a single individual

2012

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Concurrent B-cell chronic lymphocytic leukemia and multiple myeloma treated successfully with lenalidomide

Cited by 14 publications

References 30 publications

Diagnostic and Clinical Considerations in Concomitant Bone Marrow Involvement by Plasma Cell Myeloma and Chronic Lymphocytic Leukemia/Monoclonal B-Cell Lymphocytosis: A Series of 15 Cases and Review of Literature

Diagnostic and Clinical Considerations in Concomitant Bone Marrow Involvement by Plasma Cell Myeloma and Chronic Lymphocytic Leukemia/Monoclonal B-Cell Lymphocytosis: A Series of 15 Cases and Review of Literature

Concomitant Presence of Two Distinct Clones of Chronic Lymphocytic Leukemia and Plasma Cell Myeloma in a Patient

Concomitant Waldenstrom macroglobulinemia and IgA plasmablastic myeloma in a patient with untreated IgM paraproteinemia: sequential development of biclonal B-cell neoplasms over a 10-year period in a single individual

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