title: Multiple myeloma patients with low proportion of circulating plasma cells had similar survival with primary plasma cell leukemia patients.
abstract: The common features shared by primary plasma cell leukemia (pPCL) and multiple myeloma (MM) with circulating plasma cells (CPCs) are peripheral blood invasion and expansion of plasma cells independent of the protective bone marrow (BM) microenvironment niche. However, few studies have addressed the relationship between pPCL and MM with CPCs. Here, we quantitated the number CPCs by conventional morphology in 767 patients with newly diagnosed MM; their clinic features were compared with those of 33 pPCL cases. When the presence of CPCs was defined as more than 2 % plasma cells per 100 nucleated cells on Wright-Giemsa stained peripheral blood smears, the incidence of MM with CPCs was 14.1 % in newly diagnosed MM. Patients with CPCs shared many clinical features with pPCL, especially clinical parameters related to tumor burden. However, no commonalities were found in immunophenotyping and cytogenetics. The prognosis of pPCL was poor, with a median progression free survival (PFS) of 12 months and an overall survival (OS) of 15 months. MM patients with CPCs had a clearly inferior PFS and OS as compared with the control cohort. Most interestingly, although the CPCs were not high enough to meet the diagnostic criteria for pPCL, the survival of MM patients with CPCs was comparable with that of pPCL, with a median PFS of 17 months and an OS of 25 months.
authors.affiliation: State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Tianjin, China.
authors.forename: Gang
authors.initials: G
authors.lastname: An
authors.forename: Xiaoqi
authors.initials: X
authors.lastname: Qin
authors.forename: Chirag
authors.initials: C
authors.lastname: Acharya
authors.forename: Yan
authors.initials: Y
authors.lastname: Xu
authors.forename: Shuhui
authors.initials: S
authors.lastname: Deng
authors.forename: Lihui
authors.initials: L
authors.lastname: Shi
authors.forename: Meirong
authors.initials: M
authors.lastname: Zang
authors.forename: Weiwei
authors.initials: W
authors.lastname: Sui
authors.forename: Shuhua
authors.initials: S
authors.lastname: Yi
authors.forename: Zengjun
authors.initials: Z
authors.lastname: Li
authors.forename: Mu
authors.initials: M
authors.lastname: Hao
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Feng
authors.forename: Fengyan
authors.initials: F
authors.lastname: Jin
authors.forename: Dehui
authors.initials: D
authors.lastname: Zou
authors.forename: Junyuan
authors.initials: J
authors.lastname: Qi
authors.forename: Yaozhong
authors.initials: Y
authors.lastname: Zhao
authors.forename: Yu-Tzu
authors.initials: YT
authors.lastname: Tai
authors.forename: Jianxing
authors.initials: J
authors.lastname: Wang
authors.forename: Lugui
authors.initials: L
authors.lastname: Qiu
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002869:Chromosome Aberrations; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D007952:Leukemia, Plasma Cell / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000473:pathology* / Q000628:therapy; D010950:Plasma Cells / Q000378:metabolism / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D014182:Transplantation, Autologous; D016896:Treatment Outcome