Plasma Cell Leukemia with Successful Upfront Venetoclax in Combination with Allogeneic Transplantation

Tang, Andy Sing Ong; Asnawi, Asral Wirda Ahmad; Koh, Alex Zhi Yang; Chong, Siew Lian; Liew, Pek Kuen; Selvaratnam, Veena; Fauzi, Alina Md; Lau, Ngee Siang; Tan, Sen Mui

doi:10.12659/ajcr.938868

Cited by 2 publications

(3 citation statements)

References 22 publications

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“…In terms of case reports, only thirteen patient cases have been published in the literature. Of the published cases, nine patients had primary PCL, while four patients had secondary PCL ( 4 – 6 , 11 – 20 ). All patients harbored t(11;14) or BCL 2 overexpression; 3 patients had 17p deletion or TP53 mutation ( 6 , 11 , 19 ); and three cases had a complex karyotype ( 14 , 15 , 18 ).…”

Section: Literature Review and Discussionmentioning

confidence: 99%

“…Of the published cases, nine patients had primary PCL, while four patients had secondary PCL ( 4 – 6 , 11 – 20 ). All patients harbored t(11;14) or BCL 2 overexpression; 3 patients had 17p deletion or TP53 mutation ( 6 , 11 , 19 ); and three cases had a complex karyotype ( 14 , 15 , 18 ). Venetoclax was given in combination in almost all cases except three patients ( 5 , 12 , 15 ) with a dose range of 100 mg to 1200 mg.…”

Section: Literature Review and Discussionmentioning

confidence: 99%

“…The majority of patients [n=6)] achieved sCR/CR ( 5 , 6 , 11 , 13 , 19 , 20 ), VGPR [n=4] ( 12 , 16 – 18 ) and PR [n=2] ( 15 ), while one patient with secondary PCL and complex karyotype was refractory to the venetoclax combination ( 14 ). The treatment was well tolerated in almost all treated patients; grade I thrombocytopenia was reported in three cases, and there was no reported tumor lysis syndrome.…”

Section: Literature Review and Discussionmentioning

confidence: 99%

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Venetoclax in the treatment of secondary plasma cell leukemia with translocation t(11;14): a case report and literature review

Elsabah,

Ghasoub,

El Omri

et al. 2024

Front. Oncol.

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IntroductionVenetoclax is a BCL-2 inhibitor with proven efficacy in patients with multiple myeloma (MM) and translocation t(11;14). However, its role in plasma cell leukemia (PCL) remains unclear. Herein, we aimed to report a case of relapsed MM with secondary PCL and t(11;14) achieving complete (CR) and durable remission with venetoclax therapy.Case presentationA 52-year-old gentleman was diagnosed with MM-free light chain lambda (ISS III) in December 2016. He received induction therapy, followed by autologous stem cell transplant. (ASCT) in May 2017 and maintenance. A year later, the patient relapsed with secondary PCL. His cytogenetics analysis revealed t(11; 14). The patient failed salvage chemotherapy and was shifted to venetoclax with dexamethasone treatment. The patient attained complete remission (CR), which was maintained for two years and a half before he developed fatal COVID-19 pneumonia.ConclusionIn comparison with the reported literature, this case report offers the latest compilation of the available evidence on the use of venetoclax in patients with PCL. Furthermore, our patient achieved CR for the longest reported durable response in literature thus far. Prospective clinical trials are needed to elucidate the optimal dosage, combination, and duration of treatment, ensuring better representation and generalizability of the findings. Meanwhile, venetoclax may be considered as a therapeutic option in patients with PCL t(11;14).

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Section: Literature Review and Discussionmentioning

confidence: 99%

Section: Literature Review and Discussionmentioning

confidence: 99%

Section: Literature Review and Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Venetoclax in the treatment of secondary plasma cell leukemia with translocation t(11;14): a case report and literature review

Elsabah,

Ghasoub,

El Omri

et al. 2024

Front. Oncol.

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Single-Center Experience of Patients with Plasma Cell Leukemia in the Era of New Therapeutics

Dampmann,

Flossdorf,

Keyl

et al. 2024

Acta Haematol

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Introduction: Plasma cell leukemia (PCL) can occur de novo as primary PCL (pPCL), or in patients with prior diagnosis of multiple myeloma (MM) as secondary PCL (sPCL). In 2021, the diagnostic criteria have been revised, establishing a new cut-off of ≥5% plasma cells in the peripheral blood. Lacking specific clinical trials, PCL is treated similarly to MM; however, outcome for patients with PCL remains poor. Here, we report outcomes for patients with pPCL and sPCL in the era of novel agents. Methods: We performed a retrospective analysis and identified 19 patients (11 pPCL, 8 sPCL) who have been treated for PCL between 2010 and 2022 at University Hospital Essen. Results: Patients with pPCL had a median overall survival (OS) of 37.8 months (95% CI: [15.4; 52.3] months) from diagnosis, with a median time to next treatment (TTNT) of 18.4 (2.0; 22.9) months. All patients were treated with a proteasome-inhibitor (PI)-based induction therapy, and the majority was consolidated with an autologous stem cell transplantation (SCT). Five of these patients received a tandem transplantation. Patients with sPCL had a median OS of only 1.5 months after diagnosis of PCL. Only 1 patient achieved a remission with daratumumab and subsequent allogenic SCT. Conclusion: With our study, we add evidence for a PI-based induction therapy followed by a consolidating autologous SCT for patients with pPCL and give further evidence that a tandem transplant concept might be beneficial. The diagnosis of sPCL remains devastating and needs new therapeutic approaches.

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Plasma Cell Leukemia with Successful Upfront Venetoclax in Combination with Allogeneic Transplantation

Cited by 2 publications

References 22 publications

Venetoclax in the treatment of secondary plasma cell leukemia with translocation t(11;14): a case report and literature review

Venetoclax in the treatment of secondary plasma cell leukemia with translocation t(11;14): a case report and literature review

Single-Center Experience of Patients with Plasma Cell Leukemia in the Era of New Therapeutics

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