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Oncotarget. 2017 Jun 16;8(45):79517-79526. doi: 10.18632/oncotarget.18535. eCollection 2017 Oct 3.

The role of frontline autologous stem cell transplantation for primary plasma cell leukemia: a retrospective multicenter study (KMM160).

Author information

1
Chonnam National University Hwasun Hospital, Hwasun, Jeollanamdo, Republic of Korea.
2
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
3
Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
4
Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
5
Kyungpook National University Hospital, Daegu, Republic of Korea.
6
Korea University School of Medicine, Seoul, Republic of Korea.
7
Kosin University Gospel Hospital, Busan, Republic of Korea.
8
Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.
9
Pusan National University Hospital, Busan, Republic of Korea.
10
Seoul National University Bundang Hospital, Seoul, Republic of Korea.
11
Seoul National University Hospital, Seoul, Republic of Korea.
12
Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea.
13
Chonbuk National University Medical School, Jeonju, Republic of Korea.
14
Yeungnam University Medical Center, Daegu, Republic of Korea.
15
Ulsan University Hospital, Ulsan, Republic of Korea.
16
Ewha Womans University School of Medicine, Seoul, Republic of Korea.
17
Gachon University Gil Medical Center, Incheon, Republic of Korea.
18
Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.

Abstract

Primary plasma cell leukemia (pPCL) is a rare and aggressive plasma cell neoplasm, with rapidly progressing clinical course. We evaluated the treatment status and survival outcomes of 69 Korean patients with pPCL. Of them, 59 patients were treated; 15 (25.4%) were treated initially with novel agent-based regimens with upfront autologous stem cell transplantation (ASCT), 7 (11.9%) with conventional chemotherapy with upfront ASCT, 21 (35.6%) with novel agent-based regimens only, and 16 (27.1%) were treated with conventional chemotherapy alone. Overall response rates after initial therapy were significantly higher in patients treated with novel agent-based regimens compared with those treated with conventional chemotherapies (75% vs. 43.4%, P = 0.026). Median progression-free survival (PFS) and overall survival (OS) were 12.2 months and 16.1 months, respectively. The median PFS of the four treatment groups-conventional chemotherapy alone, novel agents alone, conventional chemotherapy with ASCT, and novel agents with ASCT-were 1.2, 9.0, 10.5, and 26.4 months, respectively (P < 0.001); the median OS of the four treatment groups were 2.9, 12.3, 14.1, and 31.1 months, respectively (P < 0.001). The median OS was also significantly better in the patients with novel agents with ASCT versus other patients. In a multivariate analysis, an increased lactate dehydrogenase level, low albumin (< 3.5 g/dL), and non-CR after front-line treatment were independently associated with poor PFS and OS. In conclusion, the use of novel agent-based therapy with ASCT and achieving a deep response to front-line treatment are important in expecting improved PFS and OS in patients with pPCL.

KEYWORDS:

autologous stem cell transplantation; primary plasma cell leukemia; prognosis; treatment

Conflict of interest statement

CONFLICTS OF INTEREST The authors have declared no conflicts of interest.

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