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Annals of Hematology

, Volume 94, Issue 2, pp 257–264 | Cite as

Multiple myeloma patients with low proportion of circulating plasma cells had similar survival with primary plasma cell leukemia patients

  • Gang An
  • Xiaoqi Qin
  • Chirag Acharya
  • Yan Xu
  • Shuhui Deng
  • Lihui Shi
  • Meirong Zang
  • Weiwei Sui
  • Shuhua Yi
  • Zengjun Li
  • Mu Hao
  • Xiaoyan Feng
  • Fengyan Jin
  • Dehui Zou
  • Junyuan Qi
  • Yaozhong Zhao
  • Yu-Tzu Tai
  • Jianxing Wang
  • Lugui QiuEmail author
Original Article

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.

Keywords

Multiple myeloma Circulating plasma cells Primary plasma cell leukemia 

Notes

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.

Conflict of interest statement

The authors declare no conflict of interest.

Supplementary material

277_2014_2211_MOESM1_ESM.jpg (1.5 mb)
Figure S1 Myeloma patients with circulating plasma cell had a dismal OS regardless of cutoff selection; (JPEG 1502 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Gang An
    • 1
  • Xiaoqi Qin
    • 1
  • Chirag Acharya
    • 3
  • Yan Xu
    • 1
  • Shuhui Deng
    • 1
  • Lihui Shi
    • 1
  • Meirong Zang
    • 1
  • Weiwei Sui
    • 1
  • Shuhua Yi
    • 1
  • Zengjun Li
    • 1
  • Mu Hao
    • 1
  • Xiaoyan Feng
    • 1
  • Fengyan Jin
    • 2
  • Dehui Zou
    • 1
  • Junyuan Qi
    • 1
  • Yaozhong Zhao
    • 1
  • Yu-Tzu Tai
    • 3
  • Jianxing Wang
    • 1
  • Lugui Qiu
    • 1
    Email author
  1. 1.State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases HospitalChinese Academy of Medical Science and Peking Union Medical CollegeTianjinChina
  2. 2.Cancer centerThe First Hospital of Jilin UniversityChangchunChina
  3. 3.LeBow Institute for Myeloma Therapeutics and Jerome Lipper Center for Multiple Myeloma Center, Harvard Medical SchoolDana-Farber Cancer InstituteBostonUSA

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