Prognostic indicators in primary plasma cell leukaemia: a multicentre retrospective study of 117 patients

Abstract

We report a multicentre retrospective study that analysed clinical characteristics and outcomes in 117 patients with primary plasma cell leukaemia (pPCL) treated at the participating institutions between January 2006 and December 2016. The median age at the time of pPCL diagnosis was 61 years. Ninety-eight patients were treated with novel agents, with an overall response rate of 78%. Fifty-five patients (64%) patients underwent upfront autologous stem cell transplantation (ASCT). The median follow-up time was 50 months (95% confidence interval [CI] 33; 76), with a median overall survival (OS) for the entire group of 23 months (95% CI 15; 34). The median OS time in patients who underwent upfront ASCT was 35 months (95% CI 24·3; 46) as compared to 13 months (95% CI 6·3; 35·8) in patients who did not receive ASCT (P = 0·001). Multivariate analyses identified age ≥60 years, platelet count ≤100 × 10 /l and peripheral blood plasma cell count ≥20 × 10 /l as independent predictors of worse survival. The median OS in patients with 0, 1 or 2-3 of these risk factors was 46, 27 and 12 months, respectively (P < 0·001). Our findings support the use of novel agents and ASCT as frontline treatment in patients with pPCL. The constructed prognostic score should be independently validated.

Red blood cell distribution width and platelet counts are independent prognostic factors and improve the predictive ability of IPI score in diffuse large B-cell lymphoma patients

“…The potential mechanisms include protecting circulating tumor cells from attack of host's immune system as well as supporting proliferation of tumor cells [35]. But, contradictorily, in many hematological diseases, patients with low PLT have a poor prognosis, such as Ph-like acute lymphoblastic leukemia [36], hemophagocytic lymphohistiocytosis (HLH) [37], primary plasma cell leukemia (pPCL) [38] and DLBCL [39,40]. Our data demonstrated that PLT≦126.…”

Leucemia de células plasmáticas primaria: experiencia en un hospital público chileno

“…Desde la introducción de la quimioterapia en altas dosis, seguido por trasplante de médula autólogo (TAPH) en pacientes candidatos 23 , se observó una mejoría significativa en la sobrevida de pacientes con mieloma múltiple. Sin embargo, los resultados no son extrapolables a los casos de LCPp, en los que la sobrevida es francamente menor [24][25][26][27][28] . No hay estudios prospectivos fase III, por lo que no existen guías precisas de tratamiento.…”

Red blood cell distribution width and platelet counts are independent prognostic factors and improve the predictive ability of IPI score in diffuse large B-cell lymphoma patients

“…The potential mechanisms include protecting circulating tumor cells from attacking host's immune system as well as supporting proliferation of tumor cells [39]. But, contradictorily, in many hematological diseases, patients with low PLT have a poor prognosis, such as Ph-like acute lymphoblastic leukemia [40], hemophagocytic lymphohistiocytosis (HLH) [41], primary plasma cell leukemia (pPCL) [42] and DLBCL [43,44]. Our data demonstrated that PLT≦126.5×10 9 /L was associated with higher Ann Arbor stage, more extranodal sites, higher LDH, lower WBC.…”