Semih Basci, Fevzi Altuntas, Mehmet Sinan Dal, Fatma Meric Yilmaz, Mehmet Bakirtas, Nurgul Ozcan, Eda Ozcan, Merih Kizil Cakar

Clinical findings and immunophenotypic profile of plasma cell leukemia: a retrospective study in a comprehensive cancer center in Turkey

Plasma cell leukemia (PCL) is a rare (1-2 %) aggressive plasma cell dyscrasia (PCD) with a poor prognosis and characterized by the presence of more than 20% circulating plasma cells (PCs). Multicolor Flowcytometry is used for differentiating PCs in PCL. In this study, we aimed to compare the clinical, laboratory findings and immunophenotypic profiles of patients with PCL. A total of 512 patients were investigated for PCD in our hospital between 2011-2019. The immunophenotypic profile (including, CD27, CD28, CD38, CD138, CD45, CD117, CD19, CD20, CD56, CD33, CD81, and ckappa /clambda,) were evaluated retrospectively. The clinical findings, pathology reports, immunofixation electrophoresis and MFC results of three patients with PCL were reevaluated using 6 color multiparametric flow cytometry (MFC). Only three patients were diagnosed as PCL. PCs population defined by the co-expression of CD38 and CD138 was observed as 50%, 53%, 60%, respectively. Expression of each CD56, CD117, CD20, CD45 was seen in individual cases. CD19 was negative in all cases. Cytoplasmic kappa light chain expression was detected only in one case. Two of the cases were primary and the other was secondary PCL. Bortezomib-based treatment was initiated. Overall survival of primary PCL cases were 24 months and 6 months, whereas secondary PCL was four months. Co-expression of CD38 and CD138 in identifying PCs with MFC may be considered the best combination and leads to early diagnosis within hours and appropriate treatment in patients with PCL.

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