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.
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Acknowledgments
The present study was supported by the National Natural Science Fund (81400175, 81172255, 81370632), the Clinical Research Program from Ministry of Health, China (Key project 2010 to 2012), the Special Key Anticancer Research and Development Program of Tianjin Municipality (12ZCDZSY17600), the Union Youth Research Fund of Peking Union Medical College (2012-2013), the Doctoral Foundation (20131106120037).
Contributions
GA performed FISH, analyzed data, and drafted paper. XQ, YX, SD, LS, MZ, WS, SY, ZL, MH, XF, FJ, DZ, JQ, YZ treated the patients and reviewed the paper. CA, YT, and JW helped in drafting the paper and critical revision. LQ designed the research and gave the final approval of the paper.
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The authors declare no conflict of interest.
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Gang An and Xiaoqi Qin contributed equally to this work.
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Figure S1
Myeloma patients with circulating plasma cell had a dismal OS regardless of cutoff selection; (JPEG 1502 kb)
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An, G., Qin, X., Acharya, C. et al. Multiple myeloma patients with low proportion of circulating plasma cells had similar survival with primary plasma cell leukemia patients. Ann Hematol 94, 257–264 (2015). https://doi.org/10.1007/s00277-014-2211-0
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DOI: https://doi.org/10.1007/s00277-014-2211-0