Increased serum tumor markers (CA125 and CA15.3) in primary plasma cell leukemia: a case report and review of the literature.
73-year-old woman complaining of bone pain and weight loss was suspected to have a malignant disease, and extensive laboratory investigations were carried out. She was diagnosed with multiple myeloma; however, because of the finding of extremely high serum levels of CA125 and CA15.3 and focal liver lesions, a concomitant solid tumor was suspected, which was then excluded with the appropriate tests, including an ultrasound-guided liver biopsy. While being diagnosed, the patient developed a rapidly evolving plasma cell leukemia with a simultaneous increase in CA125 and CA15.3. After treatment with cyclophosphamide and dexamethasone, the peripheral blood plasma cells disappeared and there was a dramatic decrease in the CA125 and CA15.3 tumor markers. High levels of the latter can be observed in patients with aggressive plasma cell dyscrasias, an observation that is crucial in order to avoid unnecessary tests that can result in treatment delay.
Department of Hematology, Institute of Hematology and Oncology, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), University of Barcelona, Spain.
Carlos Fernández
CF
de Larrea
Maria Teresa
MT
Cibeira
Rolando
R
Vallansot
Lluís
L
Colomo
Joan
J
Bladé
D000368:Aged; D000740:Anemia; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood*; D003520:Cyclophosphamide / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007952:Leukemia, Plasma Cell / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D008099:Liver / Q000473:pathology; D018396:Mucin-1 / Q000097:blood*; D010146:Pain; D012772:Shock, Septic; D015431:Weight Loss
D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D018396:Mucin-1; D003907:Dexamethasone; D003520:Cyclophosphamide