Skip to main content
Log in

Synchronous Plasma Cell Myeloma and Acute Myeloid Leukemia in a Therapy-Naïve Patient: A Rare Occurrence

  • Case Report
  • Published:
Indian Journal of Hematology and Blood Transfusion Aims and scope Submit manuscript

Abstract

Plasma cell proliferations in patients with acute myeloid leukemia (AML) are rare, whether at presentation or during or after therapy. Interpretation requires correlation with the clinical background, drug history as well as inputs from tests for monoclonal gammopathy and end-organ damage. The major diagnostic issues stem from excluding myeloma alone with a plasmablastic morphology that mimics AML as well as reactive or polyclonal plasmacytosis occurring in a bonafide case of AML alone before rendering a rare diagnosis of true dual pathologies. We report a rare case of concurrent AML and plasma cell myeloma in a 55-year-old lady that posed a significant diagnostic challenge. The patient had significant co-morbidities complicating the clinical picture and was treatment-naïve at the time of diagnosis. Our approach to confirming the diagnosis, as well the challenges faced in flow cytometric analyses are highlighted. The pathogenesis of such dual pathologies remains unresolved, although various conjectures and theories have been propounded in literature.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

References

  1. Al-Shughair N, Al-Dawsari G, Gyger M et al (2007) Clinical significance of plasmacytosis in the day +14 bone marrow of patients with acute myeloid leukaemia undergoing induction chemotherapy. J Clin Pathol 60:520–523

    Article  PubMed  Google Scholar 

  2. Hyun BH, Kwa D, Gabaldon H et al (1976) Reactive plasmacytic lesions of the bone marrow. Am J Clin Pathol 65:921–928

    Article  CAS  PubMed  Google Scholar 

  3. Liu CT, Dahlke MB (1967) Bone marrow findings of reactive plasmacytosis. Am J Clin Pathol 48:546–551

    Article  CAS  PubMed  Google Scholar 

  4. Gavarotti P, Boccadoro M, Redoglia V et al (1985) Reactive plasmacytosis. Case report and review of the literature. Acta Haematol 73:108–110

    Article  CAS  PubMed  Google Scholar 

  5. Wulf GG, Jahns-Streubel G, Hemmerlein B et al (1998) Plasmacytosis in acute myeloid leukemia: two cases of plasmacytosis and increased IL-6 production in the AML blast cells. Ann Hematol 76:273–277

    Article  CAS  PubMed  Google Scholar 

  6. Rosenthal NS, Farhi DC (1994) Reactive plasmacytosis and lymphocytosis in acute myeloid leukemia. Hematol Pathol 8:43–51

    CAS  PubMed  Google Scholar 

  7. Luca DC, Almanaseer IY (2003) Simultaneous presentation of multiple myeloma and acute monocytic leukemia. Arch Pathol Lab Med 127:1506–1508

    PubMed  Google Scholar 

  8. Murukutla S, Arora S, Bhatt VR et al (2014) Concurrent acute monoblastic leukemia and multiple myeloma in a 66-year-old chemotherapy-naive woman. World J Oncol 5:68–71

    Google Scholar 

  9. Cleary B, Binder RA, Kales AN et al (1978) Simultaneous presentation of acute myelomonocytic leukemia and multiple myeloma. Cancer 41:1381–1386

    Article  CAS  PubMed  Google Scholar 

  10. Pasqualetti P, Colantonio D, Casale R et al (1990) Simultaneous presentation of multiple myeloma and acute myelomonocytic leukemia in the absence of previous chemotherapy. Description of a case and review of the literature. Minerva Med 81:487–493

    CAS  PubMed  Google Scholar 

  11. Raz I, Polliack A (1984) Coexistence of myelomonocytic leukemia and monoclonal gammopathy or myeloma. Simultaneous presentation in three patients. Cancer 53:83–85

    Article  CAS  PubMed  Google Scholar 

  12. Annino L, Martino P, Barsotti P et al (1980) Multiple myeloma and acute myelomonocytic leukemia: simultaneous occurrence without previous chemotherapy. Acta Haematol 64:195–200

    Article  CAS  PubMed  Google Scholar 

  13. Tursz T, Flandrin G, Brouet J-C et al (1974) Simultaneous occurrence of acute myeloblastic leukaemia and multiple myeloma without previous chemotherapy. Br Med J 2:642–643

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Parapia L, Abbott CR, Masters G et al (1982) Simultaneous presentation of acute myelomonocytic leukaemia and multiple myeloma. Acta Haematol 68:153–156

    Article  CAS  PubMed  Google Scholar 

  15. Shukla J, Patne SC, Singh NK et al (2008) Simultaneous appearance of dual malignancies of hematopoietic system-multiple myeloma and acute myeloid leukemia. Indian J Pathol Microbiol 51:118–120

    Article  PubMed  Google Scholar 

  16. Lim J, Kwon GC, Koo SH et al (2014) A case of acute promyelocytic leukemia concomitant with plasma cell myeloma. Ann Lab Med 34:152–154

    Article  PubMed  PubMed Central  Google Scholar 

  17. Attili S, Lakshmaiah KC, Madhumati M et al (2006) Simultaneous occurrence of multiple myeloma and acute myeloid leukemia. Turk J Hematol 23:209–211

    Google Scholar 

  18. Yanagimoto M, Usuki K, Iijima K et al (2003) Simultaneous occurrence of acute myeloid leukemia with multilineage dysplasia and multiple myeloma. Rinsho Ketsueki 44:19–24

    PubMed  Google Scholar 

  19. Osserman E (1967) The association between plasmacytic and monocytic dyscrasia in man: clinical and biochemical studies. In: Killander J (ed) Gamma Globulins: structure and control of biosynthesis. Interscience Publishers, New York, pp 578–583

    Google Scholar 

  20. Kim D, Kwok B, Steinberg A (2010) Simultaneous acute myeloid leukemia and multiple myeloma successfully treated with allogeneic stem cell transplantation. South Med J 103:1246–1249

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Prashant Sharma.

Ethics declarations

Conflict of interest

All contributing authors declare no conflicts of interest.

Ethical Standard

All procedures performed in this report of a single case involving a human participant were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was not obtained from the individual patient described in the case report since she could not subsequently be contacted in spite of our best efforts. We submit that this requirement be waived as no information that can reveal the patient’s identity is included in this manuscript so as to protect her privacy.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kumar, R., Srinivasan, V.K., Sharma, P. et al. Synchronous Plasma Cell Myeloma and Acute Myeloid Leukemia in a Therapy-Naïve Patient: A Rare Occurrence. Indian J Hematol Blood Transfus 32 (Suppl 1), 168–172 (2016). https://doi.org/10.1007/s12288-015-0628-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12288-015-0628-9

Keywords

Navigation