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Myeloma

Hematopoietic cell transplantation for primary plasma cell leukemia: results from the Center for International Blood and Marrow Transplant Research

Leukemia volume 26, pages 1091–1097 (2012)Cite this article

Abstract

There are limited data on hematopoietic cell transplantation (HCT) in primary plasma cell leukemia (pPCL), an aggressive plasma cell disorder. We report outcomes of 147 patients with pPCL receiving autologous (n=97) or allogeneic (n=50) HCT within 18 months after diagnosis between 1995 and 2006. Median age was 56 years and 48 years for autologous HCT and allogeneic HCT, respectively. Progression-free survival (PFS) at 3 years was 34% (95% confidence interval (CI), 23–46%) in the autologous group and 20% (95% CI, 10–34%) in the allogeneic group. Cumulative incidence of relapse at 3 years was 61% (95% CI, 48–72%) in the autologous group and 38% (95% CI, 25–53%) in the allogeneic group. Overall survival (OS) at 3 years was 64% (95% CI, 52–75%) in the autologous group and 39% (95% CI, 26–54%) in the allogeneic group. Non-relapse mortality (NRM) at 3 years was 5% (95% CI, 1–11%) in the autologous group and 41% (95% CI, 28–56%) in the allogeneic group. The encouraging OS after autologous HCT, establishes the safety and feasibility of this consolidative treatment option after initial induction therapy for pPCL. Allogeneic HCT, although associated with a significantly lower relapse rate, carries a much higher risk of NRM and no OS benefit.

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References

  1. Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders: a report of the International Myeloma Working Group. Br J Haematol 2003; 121: 749–757.

  2. Noel P, Kyle RA . Plasma cell leukemia: an evaluation of response to therapy. Am J Med 1987; 83: 1062–1068.

    Article  CAS  PubMed  Google Scholar 

  3. Dimopoulos MA, Palumbo A, Delasalle KB, Alexanian R . Primary plasma cell leukaemia. Br J Haematol 1994; 88: 754–759.

    Article  CAS  PubMed  Google Scholar 

  4. Tiedemann RE, Gonzalez-Paz N, Kyle RA, Santana-Davila R, Price-Troska T, Van Wier SA et al. Genetic aberrations and survival in plasma cell leukemia. Leukemia 2008; 22: 1044–1052.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Gertz MA . Managing plasma cell leukemia. Leuk Lymphoma 2007; 48: 5–6.

    Article  PubMed  Google Scholar 

  6. Fonseca R . Plasma Cell Leukemia. ASH Annu Meet Abstr 2009; 114: SCI–SC4, (22).

    Google Scholar 

  7. Vela-Ojeda J, Garcia-Ruiz Esparza MA, Rosas-Cabral A, Padilla-Gonzalez Y, Garcia-Chavez J, Tripp-Villanueva F et al. Intermediate doses of melphalan and dexamethasone are better than vincristine, adriamycin, and dexamethasone (VAD) and polychemotherapy for the treatment of primary plasma cell leukemia. Ann Hematol 2002; 81: 362–367.

    Article  CAS  PubMed  Google Scholar 

  8. Przepiorka D, Weisdorf D, Martin P, Klingemann HG, Beatty P, Hows J et al. 1994 Consensus Conference on Acute GVHD Grading. Bone Marrow Transplant 1995; 15: 825–828.

    CAS  PubMed  Google Scholar 

  9. Lee SJ, Vogelsang G, Gilman A, Weisdorf DJ, Pavletic S, Antin JH et al. A survey of diagnosis, management, and grading of chronic GVHD. Biol Blood Marrow Transplant 2002; 8: 32–39.

    Article  PubMed  Google Scholar 

  10. Ramsingh G, Mehan P, Luo J, Vij R, Morgensztern D . Primary plasma cell leukemia: a Surveillance, Epidemiology, and End Results database analysis between 1973 and 2004. Cancer 2009; 115: 5734–5739.

    Article  PubMed  Google Scholar 

  11. McElwain TJ, Powles RL . High-dose intravenous melphalan for plasma-cell leukaemia and myeloma. Lancet 1983; 2: 822–824.

    Article  CAS  PubMed  Google Scholar 

  12. Saccaro S, Fonseca R, Veillon DM, Cotelingam J, Nordberg ML, Bredeson C et al. Primary plasma cell leukemia: report of 17 new cases treated with autologous or allogeneic stem-cell transplantation and review of the literature. Am J Hematol 2005; 78: 288–294.

    Article  PubMed  Google Scholar 

  13. Drake MB, Iacobelli S, van Biezen A, Morris C, Apperley JF, Niederwieser D et al. Primary plasma cell leukemia and autologous stem cell transplantation. Haematologica 2010; 95: 804–809.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Musto P, Pietrantuono G, Guariglia R, Villani O, Martorelli MC, D'Auria F et al. Salvage therapy with lenalidomide and dexamethasone in relapsed primary plasma cell leukemia. Leuk Res 2008; 32: 1637–1638.

    Article  CAS  PubMed  Google Scholar 

  15. Musto P, Rossini F, Gay F, Pitini V, Guglielmelli T, D'Arena G et al. Efficacy and safety of bortezomib in patients with plasma cell leukemia. Cancer 2007; 109: 2285–2290.

    Article  CAS  PubMed  Google Scholar 

  16. Esparis-Ogando A, Alegre A, Aguado B, Mateo G, Gutierrez N, Blade J et al. Bortezomib is an efficient agent in plasma cell leukemias. Int J Cancer 2005; 114: 665–667.

    Article  CAS  PubMed  Google Scholar 

  17. Al-Nawakil C, Tamburini J, Bardet V, Chapuis N, Bourry E, Roux C et al. Bortezomib, doxorubicin and dexamethasone association is an effective option for plasma cell leukemia induction therapy. Leuk Lymphoma 2008; 49: 2012–2014.

    Article  CAS  PubMed  Google Scholar 

  18. Palumbo A, Gay F, Falco P, Crippa C, Montefusco V, Patriarca F et al. Bortezomib as induction before autologous transplantation, followed by lenalidomide as consolidation-maintenance in untreated multiple myeloma patients. J Clin Oncol 2010; 28: 800–807.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The CIBMTR is supported by Public Health Service Grant/Cooperative Agreement U24-CA76518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI), and the National Institute of Allergy and Infectious Diseases (NIAID); a Grant/Cooperative Agreement 5U01HL069294 from NHLBI and NCI; a contract HHSH234200637015C with Health Resources and Services Administration (HRSA/DHHS); two Grants N00014-06-1-0704 and N00014-08-1-0058 from the Office of Naval Research; and grants from AABB; Allos, Inc.; Amgen, Inc.; Anonymous donation to the Medical College of Wisconsin; Astellas Pharma US, Inc.; Be the Match Foundation; Biogen IDEC; BioMarin Pharmaceutical, Inc.; Biovitrum AB; BloodCenter of Wisconsin; Blue Cross and Blue Shield Association; Bone Marrow Foundation; Buchanan Family Foundation; CaridianBCT; Celgene Corporation; CellGenix, GmbH; Children's Leukemia Research Association; ClinImmune Labs; CTI Clinical Trial and Consulting Services; Eisai, Inc.; Genentech, Inc.; Genzyme Corporation; Histogenetics, Inc.; HKS Medical Information Systems; Hospira, Inc.; Kirin Brewery Co., Ltd.; The Leukemia & Lymphoma Society; Merck & Company; The Medical College of Wisconsin; Millennium Pharmaceuticals, Inc.; Miller Pharmacal Group; Milliman USA, Inc.; Miltenyi Biotec, Inc.; National Marrow Donor Program; Nature Publishing Group; Novartis Oncology; Oncology Nursing Society; Osiris Therapeutics, Inc.; Otsuka America Pharmaceutical, Inc.; Pall Life Sciences; Pfizer Inc; Schering Corporation; Sigma-Tau Pharmaceuticals; Soligenix, Inc.; StemCyte, Inc.; StemSoft Software, Inc.; Sysmex America, Inc.; THERAKOS, Inc.; Vidacare Corporation; ViraCor Laboratories; ViroPharma, Inc.; and Wellpoint, Inc.

DISCLAIMER

The views expressed in this article do not reflect the official policy or position of the National Institute of Health, the Department of the Navy, the Department of Defense or any other agency of the US Government.

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Authors and Affiliations

  1. Department of Hematology and Oncology, Massachusetts General Hospital, Boston, MA, USA

    A Mahindra

  2. Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic Foundation, Cleveland, OH, USA

    M E Kalaycio

  3. Department of Hematologie and Internal Medicine, Hospital Especialidades CMN La RAZA IMSS, Mexico, DF, Mexico

    J Vela-Ojeda

  4. Department of Medicine, Hackensack University Medical Center, Hackensack, NJ, USA

    D H Vesole

  5. Department of Biostatistics, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, USA

    M-J Zhang

  6. Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, USA

    P Li & P Hari

  7. Department of Medicine, Institute for Myeloma & Bone Cancer Research, Los Angeles, CA, USA

    J R Berenson

  8. Department of Haematology, Bristol Children's Hospital, Bristol, UK

    J M Bird

  9. Department of Hematology, Mayo Clinic Rochester, Rochester, MN, USA

    A Dispenzieri, S Kumar & R A Kyle

  10. Department of Medicine, Oregon Health and Science University, Portland, OR, USA

    J L Gajewski

  11. Department of Hematology and Oncology, Celgene Corporation, Summit, NJ, USA

    R P Gale

  12. Department of Hematology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    L Holmberg

  13. Department of Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA

    H M Lazarus

  14. Department of Medicine, Emory University Hospital, Atlanta, GA, USA

    S Lonial

  15. Department of Hematology and Oncology, Mayo Clinic Arizona, Scottsdale, AZ, USA

    J Mikhael

  16. Department of Oncohematology,

    G A Milone

  17. , FUNDALEU, Buenos Aires, Argentina

    G A Milone

  18. Department of Hematology and Oncology, LSU Health Sciences Center, Shreveport, LA, USA

    R Munker

  19. Department of Hematology and Oncology, University of Massachusetts Medical Center, Worchester, MA, USA

    R Nath

  20. Department of Medicine, St. Frances Cabrini Center for Cancer Care, Alexandria, LA, USA

    S Saccaro

  21. Department of Haematology, Royal Adelaide Hospital, Adelaide, South Australia, Australia

    L Bik To

  22. Department of Hematology and Oncology, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA

    D T Vogl

  23. Department of Hematology ad Oncology, Shands Hospital, University of Florida, Gainesville, FL, USA

    B Wirk

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  1. A Mahindra
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  2. M E Kalaycio
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  3. J Vela-Ojeda
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  4. D H Vesole
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  6. P Li
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  7. J R Berenson
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  9. A Dispenzieri
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  11. R P Gale
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  12. L Holmberg
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  13. S Kumar
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  14. R A Kyle
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  15. H M Lazarus
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  16. S Lonial
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  17. J Mikhael
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  18. G A Milone
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  19. R Munker
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  20. R Nath
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  21. S Saccaro
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  22. L Bik To
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  23. D T Vogl
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  24. B Wirk
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  25. P Hari
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Corresponding author

Correspondence to P Hari.

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Mahindra, A., Kalaycio, M., Vela-Ojeda, J. et al. Hematopoietic cell transplantation for primary plasma cell leukemia: results from the Center for International Blood and Marrow Transplant Research. Leukemia 26, 1091–1097 (2012). https://doi.org/10.1038/leu.2011.312

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  • DOI: https://doi.org/10.1038/leu.2011.312

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