Original articleClinical Characteristics and Outcomes of Patients With Primary Plasma Cell Leukemia in the Era of Novel Agent Therapy
Section snippets
Patients and Methods
We evaluated all patients with pPCL diagnosed from 2000 to 2019 at Mayo Clinic in Rochester, Minnesota. The cohort identified for this study was defined as patients with MM who have 5% or more cPCs present on morphologic evaluation of their PB smear. Data regarding these patients with pPCL were extracted from their electronic medical records with their consent. The study was conducted with approval of the institutional review board and in accordance with the principles of the Declaration of
Patient Characteristics
This cohort consisted of 68 patients with pPCL diagnosed between January 1, 2000, and December 31, 2019. Median age was 62 (range, 34-91) years and 33 (49%) were men. The median follow-up was 46 (95% CI, 29 to 90) months. At diagnosis, the median bone marrow plasma cell percentage involvement was 85% (range, 10%-100%) and the median cPC percentage detected by morphologic evaluation of the PB smear was 26% (range, 5%-93%). There were 46 (68%) patients with 20% or greater cPCs on their PB smear
Discussion
The survival outcomes of patients with pPCL in the United States have been poor, with only modest improvement during the last decade despite the incorporation of novel agents such as PIs, IMiDs, and ASCT into clinical practice.7 This in-depth patient-level review of all cases of pPCL diagnosed in the last 20 years and treated with novel agent–based induction therapy supports the mentioned observation because the median OS of this cohort was still less than 2 years. However, this study also
Conclusion
This study demonstrates the heterogeneous outcomes of patients with pPCL that appears to be driven primarily by baseline cytogenetic risk and possibly by initial depth of hematologic response to therapy. These findings have implications on evaluating the role of risk-adapted treatment approaches on the management of patients in pPCL.
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Grant Support: Research reported in this publication was supported by grants from the National Cancer Institute of the National Institutes of Health under award number K23CA218742. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This research is also supported in part by the Marion Schwartz Foundation for Multiple Myeloma.
Potential Competing Interests: The authors declare no competing interests.