title: Successful Intrathecal Chemotherapy Combined with Radiotherapy Followed by Pomalidomide and Low-Dose Dexamethasone Maintenance Therapy for a Primary Plasma Cell Leukemia Patient.
abstract: Primary plasma cell leukemia (PPCL) is a rare aggressive variant of plasma cell disorder and frequently presents with extramedullary disease. Central nervous system (CNS) involvement with PPCL has an extremely poor prognosis. We describe a 46-year-old man with PPCL treated with a combination of lenalidomide, bortezomib, and dexamethasone as induction therapy following upfront allogeneic stem cell transplantation (allo-SCT). Despite achieving a very good partial response, the patient suffered from an isolated CNS relapse 12 months after allo-SCT. He was immediately started on concurrent intrathecal chemotherapy (IT) and cranial irradiation (RT). Subsequently, pomalidomide and low-dose dexamethasone (Pd) were given as maintenance therapy. He has been without CNS recurrence for more than 18 months. Our case suggests that concurrent IT and RT followed by Pd maintenance therapy may be an effective option to control CNS relapse of PPCL after allo-SCT.
authors.affiliation: Department of Hematology/Oncology, Wakayama Medical University , Wakayama, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Yamashita
authors.affiliation: Department of Hematology/Oncology, Wakayama Medical University , Wakayama, Japan.
authors.forename: Shinobu
authors.initials: S
authors.lastname: Tamura
authors.affiliation: Department of Hematology/Oncology, Wakayama Medical University , Wakayama, Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Oiwa
authors.affiliation: Department of Hematology/Oncology, Wakayama Medical University , Wakayama, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kobata
authors.affiliation: Department of Hematology/Oncology, Wakayama Medical University , Wakayama, Japan.
authors.forename: Kodai
authors.initials: K
authors.lastname: Kuriyama
authors.affiliation: Department of Hematology/Oncology, Wakayama Medical University , Wakayama, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Mushino
authors.affiliation: Department of Hematology/Oncology, Wakayama Medical University , Wakayama, Japan.
authors.forename: Shogo
authors.initials: S
authors.lastname: Murata
authors.affiliation: Department of Hematology/Oncology, Wakayama Medical University , Wakayama, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Hosoi
authors.affiliation: Department of Hematology/Oncology, Wakayama Medical University , Wakayama, Japan.
authors.forename: Akinori
authors.initials: A
authors.lastname: Nishikawa
authors.affiliation: Department of Hematology/Oncology, Wakayama Medical University , Wakayama, Japan.
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Hanaoka
authors.affiliation: Department of Hematology/Oncology, Wakayama Medical University , Wakayama, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Sonoki
keywords: Allogeneic stem cell transplantation; Central nervous system relapse; Pomalidomide; Primary plasma cell leukemia