Combination Chemotherapy with Bortezomib, Cyclophosphamide and Dexamethasone may be Effective for Plasma Cell Leukemia

Abstract

Plasma cell leukemia is a rare malignant plasma cell disorder characterized by proliferation of plasma cells in blood and the bone marrow, the outcome of which is poor with conventional therapy. More effective treatment strategies are therefore needed for this disorder. Here, we report a case of secondary plasma cell leukemia from Immunoglobulin D multiple myeloma refractory to doxorubicin-containing chemotherapy and thalidomide. The patient achieved complete remission with bortezomib-containing chemotherapy as follows: bortezomib 1.3 mg/m2 intravenous infusion on days 1, 4, 8 and 11; cyclophosphamide 750 mg/m(2) intravenous infusion on days 1 and 3; dexamethasone 40 mg/m2 intravenous infusion on days 1-4. Complete remission was maintained until the fourth course of the treatment, and we then performed autologous peripheral blood stem cell transplantation. Our experience suggests that combination chemotherapy with bortezomib, cyclophosphamide and dexamethasone may be an effective induction treatment for plasma cell leukemia.