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Stem cell biology

Hematopoietic cell transplantation utilization and outcomes for primary plasma cell leukemia in the current era

Leukemia volume 34, pages 3338–3347 (2020)Cite this article

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A Correction to this article was published on 05 June 2021

A Correction to this article was published on 29 March 2021

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Abstract

The outcomes of patients with primary plasma cell leukemia (pPCL) after undergoing hematopoietic cell transplantation (HCT) in the novel agent era are unknown. We report outcomes of 348 patients with pPCL receiving autologous (auto-) HCT (n = 277) and allogeneic (allo-) HCT (n = 71) between 2008 and 2015. Median age was 60 years and 56 years for auto- and allo-HCT respectively. For auto-HCT, the 4-year outcomes were: non-relapse mortality (NRM) 7% (4–11%), relapse (REL) 76% (69–82%), progression-free survival (PFS) 17% (13–23%), and overall survival (OS) 28% (22–35%). Karnofsky performance status (KPS) > 90 and ≥very good partial response (VGPR) predicted superior OS in multi-variate analysis for auto-HCT. For allo-HCT, the 4-year outcomes were: NRM 12% (5–21%), REL 69% (56–81%), PFS 19% (10–31%), and OS 31% (19–44%). Compared with prior CIBMTR pPCL patients (1995–2006), inferior survival was noted in the current cohort (3-year OS, 39% vs. 38% in allo-HCT, and 62% vs. 35% in auto-HCT) respectively. However, we noted an increased HCT utilization, from 12% (7–21%) in 1995 to 46% (34–64%) in 2009 using SEER data (available till 2009). Despite modern induction translating to higher proportion receiving HCT, the outcomes remain poor in pPCL patients, mainly derived by high relapse rates post-HCT.

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Fig. 1: Survival of plasma cell leukemia after HCT.
Fig. 2: Non-relapse mortality and relapse of plasma cell leukemia after HCT.

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Acknowledgements

The CIBMTR is supported primarily by Public Health Service U24CA076518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID); U24HL138660 from NHLBI and NCI; U01HL128568 from the NHLBI; HHSH250201700006C, and HHSH250201700007C from the Health Resources and Services Administration (HRSA); and N00014-20-1-2705 and N00014-20-1-2832 from the Office of Naval Research; Additional federal support is provided by P01CA111412, R01CA152108, R01CA215134, R01CA218285, R01CA231141, R01AI128775, R01HL126589, R01HL129472, R01HL130388, R01HL131731, U01AI069197, U01AI126612, UG1HL06924, and BARDA. Support is also provided by Be the Match Foundation, Boston Children’s Hospital, Dana Farber, St. Baldrick’s Foundation, Stanford University, the Medical College of Wisconsin the National Marrow Donor Program, and from the following commercial entities: Actinium Pharmaceuticals, Inc.; Adienne SA; Allovir, Inc.; Amgen, Inc.; Angiocrine Bioscience; Astellas Pharma US; bluebird bio, Inc.; Bristol Myers Squibb Co.; Celgene Corp.; CSL Behring; CytoSen Therapeutics, Inc.; Daiichi Sankyo Co., Ltd.; ExcellThera; Fate Therapeutics; Gamida-Cell, Ltd.; Genentech Inc; Incyte Corporation; Janssen/Johnson & Johnson; Jazz Pharmaceuticals, Inc.; Kiadis Pharma; Kite, a Gilead Company; Kyowa Kirin; Legend Biotech; Magenta Therapeutics; Merck Sharp & Dohme Corp.; Millennium, the Takeda Oncology Co.; Miltenyi Biotec, Inc.; Novartis Pharmaceuticals Corporation; Omeros Corporation; Oncoimmune, Inc.; Orca Biosystems, Inc.; Pfizer, Inc.; Pharmacyclics, LLC; Sanofi Genzyme; Stemcyte; Takeda Pharma; Vor Biopharma; Xenikos BV. 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, Health Resources and Services Administration (HRSA) or any other agency of the U.S. Government.

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Authors and Affiliations

  1. CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA

    Binod Dhakal, Raphael Fraser, Omar Davila, Saurabh Chhabra, Parameswaran Hari & Anita D’Souza

  2. Blood and Marrow Transplant Program, University of Utah, Salt Lake City, UT, USA

    Sagar Patel

  3. Trihealth Cancer Institute, Cincinnati, OH, USA

    Saulius Girnius

  4. MD Anderson Cancer Center, Houston, TX, USA

    Lohith Bachegowda & Muzaffar Qazilbash

  5. Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA

    Raphael Fraser

  6. Osborn Hematopoietic Malignancy and Transplantation Program, West Virginia University, Morgantown, WV, USA

    Abraham S. Kanate

  7. NYPH/ Columbia University Medical Center, New York, NY, USA

    Amer Assal

  8. King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia

    Amr Hanbali

  9. Blood and Marrow Transplant Program at Northside Hospital, Atlanta, GA, USA

    Asad Bashey

  10. Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Internal Medicine, The University of Michigan Medical School, Ann Arbor, MI, USA

    Attaphol Pawarode

  11. Texas Transplant Institute, San Antonio, TX, USA

    César O. Freytes

  12. Royal Adelaide Hospital, Adelaide, SA, Australia

    Cindy Lee

  13. John Theurer Cancer Center at Hackensack UMC, Hackensack, NJ, USA

    David Vesole

  14. Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA

    Robert Frank Cornell

  15. Markey Cancer Center, University of Kentucky, Lexington, KY, USA

    Gerhard C. Hildebrandt

  16. Division of Hematology Oncology, Blood and Marrow Transplantation Program, Mayo Clinic Florida, Jacksonville, FL, USA

    Hemant S. Murthy & Mohamed A. Kharfan-Dabaja

  17. Case Western Reserve University, Cleveland, OH, USA

    Hillard M. Lazarus

  18. Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA, USA

    Jan Cerny

  19. Blood & Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD, USA

    Jean A. Yared

  20. Cancer Transplant Institute, Virginia G. Piper Cancer Center, Scottsdale, AZ, USA

    Jeffrey Schriber

  21. Arizona Oncology, Scottsdale, AZ, USA

    Jeffrey Schriber

  22. Sarah Cannon BMT Program, Nashville, TN, USA

    Jesus Berdeja

  23. Washington University/Barnes Jewish Hospital, St. Louis, MO, USA

    Keith Stockerl-Goldstein

  24. Dartmouth Hitchcock Medical Center, Lebanon, NH, USA

    Kenneth Meehan

  25. Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Leona Holmberg

  26. The Blood and Marrow Transplant Group of Georgia, Northside Hospital, Atlanta, GA, USA

    Melhem Solh

  27. Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain

    Miguel Angel Diaz

  28. Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL, USA

    Nosha Farhadfar

  29. FLHospital Infantil Universitario Nino Jesus, Madrid, Spain

    Nosha Farhadfar

  30. Department of Stem Cell Transplantation & Cellular Therapy, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Qaiser Bashir, Yago Nieto & Nina Shah

  31. Markey Cancer Center, University of Kentucky, Lexington, KY, USA

    Reinhold Munker

  32. Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden

    Richard F. Olsson

  33. Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden

    Richard F. Olsson

  34. Hematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, UK

    Robert P. Gale

  35. North Shore University Hospital, Manhasset, NY, USA

    Ruthlee-Lu Bayer

  36. Department of Haematology and Oncology, Dokkyo Medical University, Tochigi, Japan

    Sachiko Seo

  37. Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA

    Shahrukh Hashmi

  38. Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

    Shahrukh Hashmi

  39. Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA

    Sherif M. Badawy

  40. Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Sherif M. Badawy

  41. Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

    Taiga Nishihori

  42. Mayo Clinic Rochester, Rochester, MN, USA

    Wilson Gonsalves & Shaji Kumar

  43. Ohio State medical Center, James Cancer Center, Columbus, OH, USA

    Yvonne Efebera

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  1. Binod Dhakal
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  2. Sagar Patel
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  43. Shaji Kumar
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  44. Nina Shah
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  46. Parameswaran Hari
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  47. Anita D’Souza
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Corresponding author

Correspondence to Anita D’Souza.

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Conflict of interest

The following authors have conflict of interest: BD reports honorarium from Celgene; Advisory board for Takeda and Amgen. HML reports Bristol Myers Squibb and Celgene. RPG reports Celgene Corporation. KS-G reports Abbot and AbbVie. AA reports research funding from Incyte Corporation; Advisory board for Boston Biomedical and Incyte Corporation. Consulting for Alpha Insights. LH reports Up-To-Date. NS reports funding from Celgene, Bluebird Bio, Sutro Biopharma; Advisory role for Genentech, Seattle Genetics, Oncopeptides, Karoypharm, Surface Oncology, Precision Biosciences, GSK, Nektar, Amgen, Indapta Therapeutics, Sanofi; Stock Ownership for Indapta Therapeutics. ADS reports funding from Merck, Prothena, Sanofi, Mundipharma EDO, TeneoBio, Takeda and has received consulting fees from Prothena, Pfizer, Imbrium, and Akcea.

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The original online version of this article was revised: The acknowledgement of the original article was incomplete. Correct is should read: The CIBMTR is supported primarily by Public Health Service U24CA076518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID); U24HL138660 from NHLBI and NCI; U01HL128568 from the NHLBI; HHSH250201700006C, and HHSH250201700007C from the Health Resources and Services Administration (HRSA); and N00014-20-1-2705 and N00014-20-1-2832 from the Office of Naval Research; Additional federal support is provided by P01CA111412, R01CA152108, R01CA215134, R01CA218285, R01CA231141, R01AI128775, R01HL126589, R01HL129472, R01HL130388, R01HL131731, U01AI069197, U01AI126612, UG1HL06924, and BARDA. Support is also provided by Be the Match Foundation, Boston Children’s Hospital, Dana Farber, St. Baldrick’s Foundation, Stanford University, the Medical College of Wisconsin the National Marrow Donor Program, and from the following commercial entities: Actinium Pharmaceuticals, Inc.; Adienne SA; Allovir, Inc.; Amgen, Inc.; Angiocrine Bioscience; Astellas Pharma US; bluebird bio, Inc.; Bristol Myers Squibb Co.; Celgene Corp.; CSL Behring; CytoSen Therapeutics, Inc.; Daiichi Sankyo Co., Ltd.; ExcellThera; Fate Therapeutics; Gamida-Cell, Ltd.; Genentech Inc; Incyte Corporation; Janssen/Johnson & Johnson; Jazz Pharmaceuticals, Inc.; Kiadis Pharma; Kite, a Gilead Company; Kyowa Kirin; Legend Biotech; Magenta Therapeutics; Merck Sharp & Dohme Corp.; Millennium, the Takeda Oncology Co.; Miltenyi Biotec, Inc.; Novartis Pharmaceuticals Corporation; Omeros Corporation; Oncoimmune, Inc.; Orca Biosystems, Inc.; Pfizer, Inc.; Pharmacyclics, LLC; Sanofi Genzyme; Stemcyte; Takeda Pharma; Vor Biopharma; Xenikos BV. 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, Health Resources and Services Administration (HRSA) or any other agency of the U.S. Government.

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Dhakal, B., Patel, S., Girnius, S. et al. Hematopoietic cell transplantation utilization and outcomes for primary plasma cell leukemia in the current era. Leukemia 34, 3338–3347 (2020). https://doi.org/10.1038/s41375-020-0830-0

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