Plasma cell leukemia occurring in a patient with thrombocythemia treated with hydroxyurea and busulphan.
Plasma cell leukemia (PCL) is a rare aggressive lymphoproliferative disease with a short median survival and a very poor prognosis. We report the case of a 63-year-old man who developed a PCL after 5 years of chemotherapy with hydroxyurea and busulphan for Essential thrombocythemia (ET). The karyotype showed a deletion of chromosome 7 and the plasma cells cytofluorimetric examination revealed a high expression of Multidrug Resistance related P-glycoprotein (PGP). After the second cycle of VAD chemotherapy the patient had a severe pneumonia and died with refractory PCL. This is a rare example of the coexistence of a chronic myeloproliferative and lymphoproliferative diseases in the same patient, and to the best of our knowledge, the first reported in the literature involving PCL and ET. Moreover, this case shows the possibility of secondary malignancies developing in patients treated with busulphan and hydroxyurea for chronic myeloproliferative disorders.
Candoni
Anna
A
Division of Hematology and Bone Marrow Transplantation, Department of Medical and Morphological Researches, University Hospital, Udine, Italy. candoni.a@tiscali.it
Tiribelli
Mario
M
Fanin
Renato
R
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000032:analysis; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D002066:Busulfan / Q000009:adverse effects; D002872:Chromosome Deletion; D017809:Fatal Outcome; D006801:Humans; D006918:Hydroxyurea / Q000009:adverse effects; D007952:Leukemia, Plasma Cell / Q000139:chemically induced* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000139:chemically induced / Q000209:etiology; D013920:Thrombocythemia, Essential / Q000150:complications* / Q000188:drug therapy*
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D002066:Busulfan; D006918:Hydroxyurea