A case report of a young female with plasma cells leukemia

Abstract

Plasma cell leukemia (PCL) is a rare and aggressive variant of plasma cell dyscrasias that can occur either de novo (primary) or as a leukemic transformation of end-stage multiple myeloma (MM). PCL is known with a poor prognosis and with a different biologic background, clinical, and laboratory features. Primary PCL presents more often with extramedullary involvement, anemia, thrombocytopenia, hypercalcemia, elevated serum 2-microglobulin, and lactate dehydrogenase levels, in addition to impaired renal function in comparison with MM. Here, we report a case of a young female who was admitted with excessive thirst, polyuria, lower backache, fever, and weight loss over 2 months. Peripheral blood smear showed numerous atypical looking plasma cells, and immunophenotyping on bone marrow (BM) aspirate demonstrated the presence of clonal plasma cells. She was admitted to adult hematology ward in Hiwa Hemato-Oncology Hospital, Sulaimani, Kurdistan, Iraq and received four cycles of bortezomib, thalidomide, and dexamethasone chemotherapy, followed by two more cycles of dexamethasone, cyclophosphamide, etoposide, and cisplatin, and later, she proceeded to autologous BM transplantation. More details of the case are presented below.