Abid Jameel.
Plasma Cell Leukemia: Case report of a rare and aggressive variant of multiple myeloma.
J Pak Med Assoc Jul ;55(10):452-4.

Plasma cell leukemia (PCL) is a rare disease and is the least common variant of multiple myeloma accounting for 2-3% of all plasma cell dyscrasias. We report a patient who presented with history of high grade fever, weakness, palpitations, loss of appetite, bone pains and mental confusion for twenty days. Initial evaluation revealed plasmacytosis with blood plasma cell count of 5184/cumm. His hemoglobin (Hb) was 11.3 gm/dl, platelets were 75000/cumm and total leucocyte count (TLC) was 21600/cumm (24% plasma cells). Bone marrow examination revealed >60% plasmablasts. Serum LDH was high at 3117 U/L and serum calcium was also elevated at 13.9 mg/dl. A diagnosis of PCL was made and the patient was started on treatment for hypercalcaemia with Melphalan/Prednisolone regime along with supportive care. Patient deteriorated very rapidly despite treatment and died on the eighth day. A detailed report of this case and a review of PCL is presented here.


USER COMMENTS

PCL is an aggressive malignancy.Novel therapeutics include High Dose Therapy, Thalidomide and Velcade(Bortezomib).In the abscence of these therapies,the outcome is rather poor. Complete Remissions are rare. Syed Ayub Mazher DOW (86) Practicing Oncologist Little Rock,Arkansas USA email:syed.mazher@usoncology.com
Posted by: smazher on Nov 2005

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