PLASMA CELL LEUKAEMIA: A RARE YET AGGRESSIVE PLASMA CELL DYSCRASIA WITH A VERY POOR RESPONSE TO CONVENTIONAL THERAPY

Authors

  • Najeebullah Khan Najeebullah Khan EMAIL: (najeebkhan920@gmail.com) Core Medical Trainee, Northampton General Hospital, UK.
  • Syed Shahmeer Raza Syed Shahmeer Raza (Corresponding author) * EMAIL: (shamir.raza@gmail.com) Department of Medicine, Medicine B Unit, Hayatabad Medical Complex, Peshawar, Pakistan. 25000
  • Uzma Ikhtiar Khan Uzma Ikhtiar Khan EMAIL: (dr.uzmaikhtiarkhan@gmail.com) House Officer, Internal Medicine, Khyber Teaching Hospital Peshawar, Pakistan.
  • Irfanullah . Irfanullah EMAIL: (irfanullah6686@yahoo.com) Trust Grade CT, Northampton General Hospital, UK.
  • Hafez Mohammad Ammar Abdullah Hafez Mohammad Ammar Abdullah EMAIL: (dr.ammarabdullah@gmail.com) Internal Medicine Resident, University of South Dakota Sanford School Of Medicine, USA.
  • Masroor Hassan Masroor Hasan EMAIL: (dr_masroor313@yahoo.com) Resident Physician, Department of Pathology, Rehman Medical Institute Peshawar, Pakistan.
  • Asfandiar Shah Rukh Hijaz Asfandiar Shah Rukh Hijaz EMAIL: (shahrukhhijaz@gmail.com) Department of Medicine, Medicine B Unit, Hayatabad Medical Complex, Peshawar, Pakistan. 25000
  • Amer Kamal Hussain Amer Kamal Hussain EMAIL: (amerkamalhussain1@gmail.com) Department of Surgery, Surgery B Unit, Hayatabad Medical Complex, Peshawar, Pakistan. 25000
  • Muhammad Daniyal Nadeem Muhammad Daniyal Nadeem EMAIL: (daniyal816@gmail.com) Department of Medicine, Medicine B Unit, Hayatabad Medical Complex, Peshawar, Pakistan. 25000

Abstract

Plasma cell leukaemia (PCL) is a very rare plasma cell dyscrasia with a significant number of monoclonal plasma cells in the peripheral blood. It is diagnosed by the presence of ≥ 2x109 /L plasma cells in the blood or by plasma cells making up ≥20% of the leukocyte count. It can arise from a leukemic transformation of multiple myeloma, or more commonly it can be primary. Regardless of its origin, it carries a very dire prognosis. It responds very poorly to the traditional chemotherapy regimens used for multiple myeloma. We present the case of a 50 years old female who presented to our hospital with a complicated UTI and severe generalized body aches. She was diagnosed as a case of plasma cell leukaemia and was treated with cyclophosphamide and dexamethasone, however she failed to go into remission. Her condition deteriorated and she ultimately passed away 1.5 months after diagnosis. The recommended treatment for PCL is aggressive combination chemotherapy followed by stem cell transplantation. However, there is no consensus regarding the treatment of plasma cell leukaemia, and treatment should be individualized based on the patient profile. Once diagnosed, the prognosis is poor.Keywords: Plasma Cell Leukaemia; Multiple Myeloma; Plasma Cell Dyscrasia; Bortezomib

Author Biographies

Najeebullah Khan, Najeebullah Khan EMAIL: (najeebkhan920@gmail.com) Core Medical Trainee, Northampton General Hospital, UK.

Najeebullah KhanEMAIL: (najeebkhan920@gmail.com)Core Medical Trainee, Northampton General Hospital, UK.

Syed Shahmeer Raza, Syed Shahmeer Raza (Corresponding author) * EMAIL: (shamir.raza@gmail.com) Department of Medicine, Medicine B Unit, Hayatabad Medical Complex, Peshawar, Pakistan. 25000

Syed Shahmeer Raza (Corresponding author) *EMAIL: (shamir.raza@gmail.com)Department of Medicine, Medicine B Unit, Hayatabad Medical Complex, Peshawar, Pakistan. 25000

Uzma Ikhtiar Khan, Uzma Ikhtiar Khan EMAIL: (dr.uzmaikhtiarkhan@gmail.com) House Officer, Internal Medicine, Khyber Teaching Hospital Peshawar, Pakistan.

Uzma Ikhtiar KhanEMAIL: (dr.uzmaikhtiarkhan@gmail.com)House Officer, Internal Medicine, Khyber Teaching Hospital Peshawar, Pakistan. 

Hafez Mohammad Ammar Abdullah, Hafez Mohammad Ammar Abdullah EMAIL: (dr.ammarabdullah@gmail.com) Internal Medicine Resident, University of South Dakota Sanford School Of Medicine, USA.

Hafez Mohammad Ammar AbdullahEMAIL: (dr.ammarabdullah@gmail.com)Internal Medicine Resident, University of South Dakota Sanford School Of Medicine, USA.

Amer Kamal Hussain, Amer Kamal Hussain EMAIL: (amerkamalhussain1@gmail.com) Department of Surgery, Surgery B Unit, Hayatabad Medical Complex, Peshawar, Pakistan. 25000

Amer Kamal HussainEMAIL: (amerkamalhussain1@gmail.com)Department of Surgery, Surgery B Unit, Hayatabad Medical Complex, Peshawar, Pakistan. 25000

Muhammad Daniyal Nadeem, Muhammad Daniyal Nadeem EMAIL: (daniyal816@gmail.com) Department of Medicine, Medicine B Unit, Hayatabad Medical Complex, Peshawar, Pakistan. 25000

Muhammad Daniyal NadeemEMAIL: (daniyal816@gmail.com)Department of Medicine, Medicine B Unit, Hayatabad Medical Complex, Peshawar, Pakistan. 25000 

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Published

2019-03-29