Effective autologous peripheral blood stem cell transplantation in plasma cell leukemia followed by T-large granular lymphocyte expansion: a case report.
We report a case of de novo plasma cell leukemia, resistant to standard VMD (vincristine, mitoxantrone, dexamethasone) and CVP (cyclophosphamide, vincristine and prednisone) protocols, treated with a chemotherapy intensification regimen (high-dose cyclophosphamide, modified EDAP, Dexa-BEAM) and peripheral blood stem cell transplantation, performed using fractionated total body irradiation and high dose melphalan. The patient is currently alive and well, in very good partial remission 12 months after transplant and 22 months after diagnosis, disclosing a significant proportion of bone marrow and peripheral blood CD3+, CD8+, CD57+, HLA-Dr+ large granular lymphocytes with cytotoxic activity against neoplastic plasma cells.
Sajeva
M R
MR
Division of Hematology, IRCCS Casa Sollievo della Sofferenza Hospital, S Giovanni Rotondo, Italy.
Greco
M M
MM
Cascavilla
N
N
D'Arena
G
G
Scalzulli
P
P
Melillo
L
L
Minervini
M M
MM
Bonini
A
A
Di Mauro
L
L
Carotenuto
M
M
Musto
P
P
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002330:Carmustine / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007952:Leukemia, Plasma Cell / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D018655:Lymphocyte Count; D008297:Male; D008558:Melphalan / Q000008:administration & dosage / Q000627:therapeutic use; D008942:Mitoxantrone / Q000008:administration & dosage; D011241:Prednisone / Q000008:administration & dosage; D012074:Remission Induction; D016176:T-Lymphocyte Subsets; D019172:Transplantation Conditioning; D014750:Vincristine / Q000008:administration & dosage; D014916:Whole-Body Irradiation
D003561:Cytarabine; D014750:Vincristine; D005047:Etoposide; D003907:Dexamethasone; D003520:Cyclophosphamide; D008942:Mitoxantrone; D002945:Cisplatin; D008558:Melphalan; D002330:Carmustine; D011241:Prednisone