Successful treatment of primary plasma cell leukaemia by allogeneic stem cell transplantation from haploidentical sibling.
Primary plasma cell leukaemia (PCL) is a rare, aggressive neoplasm of plasma cell dyscrasia. Conventional chemotherapy is usually ineffective, with an overall survival of only 8 months. Here, we describe a 42-year-old man with primary PCL, who was successfully treated with haploidentical (2-HLA loci mismatched) haematopoietic stem-cell transplantation (HSCT). To overcome the human leukocyte antigen (HLA) disparity, in vivo T-cell purging by the pre-transplant administration of antithymocyte globulin followed by a conventional prophylactic treatment against graft-versus-host disease (GVHD) resulted in an avoidance of severe GVHD as well as infectious complications. The patient has maintained complete remission for 13 months after haploidentical HSCT, indicating that a graft-versus-PCL effect might be preserved. Haploidentical HSCT can be a potentially curative treatment for patients with primary PCL who do not have an HLA-identical donor.
Nonami
Atsushi
A
First Department of Internal Medicine, Graduate School of Medicine, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. anonamin@yahoo.co.jp
Miyamoto
Toshihiro
T
Kuroiwa
Mika
M
Kunisaki
Yuya
Y
Kamezaki
Kenjiro
K
Takenaka
Katsuto
K
Harada
Naoki
N
Teshima
Takanori
T
Harada
Mine
M
Nagafuji
Koji
K
D000328:Adult; D000961:Antilymphocyte Serum / Q000008:administration & dosage; D016465:Bone Marrow Purging; D006086:Graft vs Host Disease / Q000517:prevention & control; D006239:Haplotypes; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007952:Leukemia, Plasma Cell / Q000235:genetics / Q000601:surgery*; D008297:Male; D035781:Siblings; D013601:T-Lymphocytes; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents