title: Leukaemic Transformation of Multiple Myeloma in Post Chemotherapy Remission Phase.
abstract: Plasma cell leukaemia is diagnosed when plasma cells are >20% in the peripheral blood. Plasma cell leukaemia may be present at the time of diagnosis (primary plasma cell leukaemia) or may evolve from multiple myeloma (secondary plasma cell leukaemia). We report case of a 62-year-old male who was diagnosed with multiple myeloma. He was treated with combination of prednisolone, melphalan and thalidomide. After 6 years he had Worsening of symptoms and also developed a scalp swelling. The swelling was diagnosed as plasmacytoma on fine needle aspiration cytology and confirmed on histopathology. Complete haemogram showed-Haemoglobin - 8g/dl, Total Leucocyte Count - 4300/μl, Differential leucocyte count - Neutrophil-40%, Lymphocyte-28%, Eosinophil-01%, Monocyte-10%, Atypical cells-21%, Platelet count- 1.5 lacs/μl. Peripheral blood showed rouleaux formation and plasma cells. Serum protein electrophoresis revealed an M spike (3.26 g/dl). So, patient was diagnosed as secondary plasma cell leukaemia. Weekly bortezomib and dexamethasone combination chemotherapy was given to the patient. Patient is on monthly follow up. Here we present a detailed case history of this patient.
authors.affiliation: Department of Pathology, Kriti Scanning Centre Pvt Ltd , Allahabad, India .
authors.forename: Palak
authors.initials: P
authors.lastname: Agarwal
authors.affiliation: Department of Pathology, Anoop Labs Pvt Ltd , Allahabad, India .
authors.forename: Prachi
authors.initials: P
authors.lastname: Nayak
authors.affiliation: Department of Pathology, Anoop Labs Pvt Ltd , Allahabad, India .
authors.forename: Premala Anthony
authors.initials: PA
authors.lastname: Singh
authors.affiliation: Department of Medicine, Kriti Scanning Centre Pvt Ltd , Allahabad, India .
authors.forename: Bal Krishna
authors.initials: BK
authors.lastname: Mishra
keywords: Bone Marrow; Bortezomib; Hemogram; SPEP