[Successful VEP-IFN-alpha therapy in a case of non-secretory plasma cell leukemia (BJ-kappa type)].
Plasma cell leukemia is a rare disorder with poor prognosis. We present a case of non-secretory primary plasma cell leukemia (Bence-Jones kappa type), which was treated successfully by VEP-IFN-alpha therapy. A 82-year old man was admitted to Kanazawa Medical University in May 1991, because of emaciation and dehydration. Clinical findings showed decreased level of gamma-globulin (IgG, IgA and IgM were all decreased markedly), hypercalcemia, renal dysfunction and increased serum beta-2 microglobulin. The peripheral blood leukocyte count was 30,100/microliters with 64% plasma cells, and 80.4% plasma cells were also observed in the bone marrow. Only light chain-kappa was detected in plasma cells by an immunohistochemical staining method, but immunoelectrophoresis showed no M-bow either in serum or urine. Electron microscopy revealed typical plasma cells with prominently developed rough endoplasmic reticulum. From these results, the diagnosis of non-secretory primary plasma cell leukemia was established. He was treated with VEP-IFN-alpha regimen, and plasma cells decreased markedly in both peripheral blood and bone marrow. Serum immunoglobulin recovered to within the normal range. After 6 courses of VEP-IFN-alpha, complete remission was achieved and the remission was maintained until he died of an unrelated event, bronchial obstruction due to misswallowing, in April 1992.
Masaki
Y
Y
Department of Internal Medicine, Kanazawa Medical University.
Shimizu
S
S
Takeshita
S
S
Fukutoku
M
M
Yoshioka
R
R
Arai
T
T
Hirose
Y
Y
Sugai
S
S
Konda
S
S
Takiguti
T
T
D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000032:analysis; D007145:Immunoglobulin kappa-Chains / Q000032:analysis; D016898:Interferon-alpha / Q000008:administration & dosage*; D007952:Leukemia, Plasma Cell / Q000628:therapy*; D008297:Male; D011239:Prednisolone / Q000008:administration & dosage; D014751:Vindesine / Q000008:administration & dosage
D007147:Immunoglobulin Light Chains; D007145:Immunoglobulin kappa-Chains; D016898:Interferon-alpha; D005047:Etoposide; D011239:Prednisolone; D014751:Vindesine