IgE plasma cell leukemia successfully treated with combination VAD (vincristine, doxorubicin, dexamethasone) and MP (melphalan, prednisolone) followed by interferon‐α

Yamagata, Noboru; Shimazaki, Chihiro; Goto, Hideo; Hirata, Toshiyuki; Ashihara, Eishi; Oku, Naritoshi; Inaba, Tohru; Fujita, Naohisa; Nakagawa, Masao

doi:10.1002/ajh.2830450315

Cited by 15 publications

(8 citation statements)

References 9 publications

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“…Otherwise, recent reports have demonstrated that maintenance with INF-α significantly prolongs the remission duration in patients with multiple myeloma responding to chemotherapy [12]. This approach could also be useful in PCL, as Yamagata et al [5]have previously described, and the present patient supports.…”

Section: Discussionsupporting

confidence: 77%

“…Combination chemotherapy with the regimens used in multiple myeloma is a better approach to the treatment of PCL because drugs like dexamethasone are active against differentiated plasma cells and could achieve a great reduction in the tumor burden, while other drugs like melphalan and INF-α are more effective in reducing the clonogenic myeloma cells [4]. Unfortunately, the studies reporting the combined use of melphalan and prednisone for PCL did not show an increase either in the rate or in the duration of remissions [5]. Combination chemotherapy with three or more drugs has also been used, and occasionally longer remissions have been described.…”

Section: Discussionmentioning

confidence: 99%

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Long-Term Survival in Primary Plasma Cell Leukemia after Therapy with VAD, Autologous Blood Stem Cell Transplantation and Interferon-Alpha

Panizo

Rifón²,

Rodríguez-Wilhelmi³

et al. 1999

Acta Haematol

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Primary plasma cell leukemia (PCL) is a rare form of plasma cell neoplasm with a poor prognosis. Conventional melphalan-based treatments have been most disappointing. We report the case of a 62-year-old man with a primary form of PCL treated with VAD combination achieving an objective response, and who received high-dose melphalan and autologous peripheral blood stem cell (PBSC) transplantation followed by interferon-α. During the remission time, lasting for 3 years, an infiltration by large granular lymphocytes (LGL) was noted in peripheral blood. However, when the number of LGL declined, a bone marrow relapse was observed. The treatment for PCL and the possible role of these LGL on tumor cell control after autologous PBSC transplantation are discussed.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Long-Term Survival in Primary Plasma Cell Leukemia after Therapy with VAD, Autologous Blood Stem Cell Transplantation and Interferon-Alpha

Panizo

Rifón²,

Rodríguez-Wilhelmi³

et al. 1999

Acta Haematol

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“…Several IgE-MM patients have been successfully treated employing conventional regimens such as MP, VAD, or interferon-a [3,18]. As our patient was much older than 65 years and also had cardiac complications, MP therapy was selected as a first line, but it had only partial, transient effects on the clinical symptoms (edema and ascites) and the reduction in serum IgE.…”

Section: Discussionmentioning

confidence: 98%

An unusual case of IgE-multiple myeloma presenting with systemic amyloidosis 2 years after cervical plasmacytoma resection

et al. 2010

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A 69-year-old man suffered from a fractured cervical vertebra, and magnetic resonance imaging revealed a solitary mass occupying the injured lesion. Surgical resection of the mass was conducted, and the infiltration of plasma cells expressing IgE-lambda monoclonal protein was shown on pathological investigation. Concurrently, a monoclonal band of IgE-lambda was shown in the sera on immunoelectrophoresis, and the proliferation of plasma cells (more than 10%) was also detected in bone marrow aspirates. A rare IgE-multiple myeloma (MM) was diagnosed, and careful monthly follow-up was started. During this observation period, the level of IgE gradually increased and, at 2 years after the initial diagnosis, bilateral leg edema and ascites with marked hepatosplenomegaly appeared. Combination chemotherapy of melphalan and prednisolone (MP) was started, which resulted in the partial, transient resolution of symptoms. Additional treatment with bortezomib and dexamethasone could neither resolve these clinical symptoms nor decrease the serum IgE concentration. At 5 months after the start of chemotherapy, amyloid deposition was suggested based on typical echocardiographic findings, and the diagnosis of amyloidosis was confirmed based on the histopathology of a liver biopsy. In spite of MP plus thalidomide treatment, cardiac failure due to amyloidosis aggravated, and the patient died of multiple organ failure. This is the second reported case in which IgE-MM was complicated by systemic amyloidosis.

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“…Macro et al [16] demonstrated a higher incidence of PCL in IgE PCDs than that in other classes of PCDs (approximately 18% vs. 1.5-2%), although the former presents various clinical pictures as well. Including our patient described, we found 8 cases of IgE-producing PCL in the literature (6 primary and 2 possible secondary PCLs [1,5,[17][18][19][20][21]) (Table 1). Notably, 4 of 6 primary IgE PCL patients had neither osteolytic skeletal lesions nor elevation of serum calcium concentrations.…”

Section: Discussionmentioning

confidence: 92%

“…IgEproducing PCDs are considered to represent less than 0.01% of all types of multiple myeloma (MM)-related diseases [4], and thus fewer than ten patients of plasma cell leukemia (PCL) with IgE secretion have been reported [5]. Clinical and pathological features of IgE PCDs have not been sufficiently analyzed because of a small number of such patients.…”

Section: Introductionmentioning

confidence: 99%

Plasma cell leukemia producing monoclonal immunoglobulin E

et al. 2009

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A 78-year-old male with lumbar pain and dim consciousness presented the clinical pictures of plasma cell leukemia (PCL) producing a large amount of monoclonal immunoglobulin E (IgE)/kappa protein. Laboratory investigation demonstrated an elevated serum calcium level and renal dysfunction. Systemic bone X-ray survey disclosed only a solitary osteolytic lesion. Circulating plasma cells demonstrated CD19(-)/CD56(-) and MPC-1(-)/CD49e(-)/CD45(+/-), the latter indicating the immature phenotype of the tumor cells. Bone marrow was occupied with immature, atypical plasma cells, of which cytoplasms were positive for IgE by direct immunofluorescence analysis. Chromosomes revealed a translocation of (11;14)(q13;q32), which is concordant with cyclinD1-protein overexpression by immunohistochemistry. He was treated with dexamethasone and vincristine, which somewhat improved the laboratory findings. He died of tumor progression after 4-month admission. The clinical and biological characteristics of IgE-producing PCL, a very rare type of plasma cell dyscrasia, are discussed, reviewing the past literature.

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IgE plasma cell leukemia successfully treated with combination VAD (vincristine, doxorubicin, dexamethasone) and MP (melphalan, prednisolone) followed by interferon‐α

Cited by 15 publications

References 9 publications

Long-Term Survival in Primary Plasma Cell Leukemia after Therapy with VAD, Autologous Blood Stem Cell Transplantation and Interferon-Alpha

Long-Term Survival in Primary Plasma Cell Leukemia after Therapy with VAD, Autologous Blood Stem Cell Transplantation and Interferon-Alpha

An unusual case of IgE-multiple myeloma presenting with systemic amyloidosis 2 years after cervical plasmacytoma resection

Plasma cell leukemia producing monoclonal immunoglobulin E

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