Successful treatment of primary plasma cell leukaemia by allogeneic stem cell transplantation from haploidentical sibling.

Primary plasma cell leukaemia (PCL) is a rare, aggressive neoplasm of plasma cell dyscrasia. Conventional chemotherapy is usually ineffective, with an overall survival of only 8 months. Here, we describe a 42-year-old man with primary PCL, who was successfully treated with haploidentical (2-HLA loci mismatched) haematopoietic stem-cell transplantation (HSCT). To overcome the human leukocyte antigen (HLA) disparity, in vivo T-cell purging by the pre-transplant administration of antithymocyte globulin followed by a conventional prophylactic treatment against graft-versus-host disease (GVHD) resulted in an avoidance of severe GVHD as well as infectious complications. The patient has maintained complete remission for 13 months after haploidentical HSCT, indicating that a graft-versus-PCL effect might be preserved. Haploidentical HSCT can be a potentially curative treatment for patients with primary PCL who do not have an HLA-identical donor.

[1]  Wei Han,et al.  Haploidentical hematopoietic stem cell transplantation without in vitro T-cell depletion for the treatment of hematological malignancies , 2006, Bone Marrow Transplantation.

[2]  S. Ogawa,et al.  In Vivo Alemtuzumab Enables Haploidentical Human Leukocyte Antigen-Mismatched Hematopoietic Stem-Cell Transplantation Without Ex Vivo Graft Manipulation , 2005, Transplantation.

[3]  C. Mecucci,et al.  Full haplotype-mismatched hematopoietic stem-cell transplantation: a phase II study in patients with acute leukemia at high risk of relapse. , 2005, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[4]  R. Fonseca,et al.  Primary plasma cell leukemia: Report of 17 new cases treated with autologous or allogeneic stem‐cell transplantation and review of the literature , 2005, American journal of hematology.

[5]  Y. Kanda,et al.  Reconstitution of HLA-A*2402-Restricted Cytomegalovirus-Specific T-Cells Following Stem Cell Transplantation , 2004, International journal of hematology.

[6]  D. Blaise,et al.  Graft-versus-myeloma effect following antithymocyte globulin-based reduced intensity conditioning allogeneic stem cell transplantation , 2004, Bone Marrow Transplantation.

[7]  P. Mehta,et al.  Primary plasma cell leukaemia. , 2004, The Journal of the Association of Physicians of India.

[8]  K. Wong,et al.  Consolidation therapy with autologous blood stem cell transplantation in a patient with primary plasma cell leukaemia. , 2003, Clinical and laboratory haematology.

[9]  U. Mlakar,et al.  Maintenance treatment of primary plasma cell leukemia with interferon alpha. , 2002, Transplantation proceedings.

[10]  J. Vela-Ojeda,et al.  Intermediate doses of melphalan and dexamethasone are better than vincristine, adriamycin, and dexamethasone (VAD) and polychemotherapy for the treatment of primary plasma cell leukemia , 2002, Annals of Hematology.

[11]  R. Bouabdallah,et al.  Primary plasma cell leukaemia: a report of 18 cases. , 2001, Leukemia research.

[12]  M. V. van Oers,et al.  Donor lymphocyte infusions for relapsed multiple myeloma after allogeneic stem-cell transplantation: predictive factors for response and long-term outcome. , 2000, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[13]  R. Kyle,et al.  Nonsecretory myeloma, immunoglobulin D myeloma, and plasma cell leukemia. , 1999, Hematology/oncology clinics of North America.

[14]  A. Órfão,et al.  Primary plasma cell leukemia: clinical, immunophenotypic, DNA ploidy, and cytogenetic characteristics. , 1999, Blood.

[15]  M. Martelli,et al.  Treatment of high-risk acute leukemia with T-cell-depleted stem cells from related donors with one fully mismatched HLA haplotype. , 1998, The New England journal of medicine.

[16]  Cai Zj [Primary plasma cell leukemia--a comprehensive analysis of 44 cases]. , 1990 .

[17]  R. Kyle,et al.  Plasma cell leukemia: an evaluation of response to therapy. , 1987, The American journal of medicine.

[18]  T. Spitzer Haploidentical stem cell transplantation: the always present but overlooked donor. , 2005, Hematology. American Society of Hematology. Education Program.

[19]  N. Schmitz,et al.  Haploidentical ‘megadose’ stem cell transplantation in acute leukemia: recommendations for a protocol agreed upon at the Perugia and Chicago meetings , 2002, Leukemia.

[20]  R. Collins,et al.  Donor leukocyte infusions for multiple myeloma , 2000, Bone Marrow Transplantation.

[21]  Z. Cai [Primary plasma cell leukemia--a comprehensive analysis of 44 cases]. , 1990, Zhonghua zhong liu za zhi [Chinese journal of oncology].