Oncotarget

Clinical Research Papers:

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

Sung-Hoon Jung, Je-Jung Lee, Kihyun Kim, Cheolwon Suh, Dok Hyun Yoon, Chang-Ki Min, Sang Kyun Sohn, Chul Won Choi, Ho Sup Lee, Hyo Jung Kim, Ho-Jin Shin, Soo-Mee Bang, Sung-Soo Yoon, Seong Kyu Park, Ho-Young Yhim, Min Kyoung Kim, Jae-Cheol Jo, Yeung-Chul Mun, Jae Hoon Lee, Jin Seok Kim _ and Korean Multiple Myeloma Working Party

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Oncotarget. 2017; 8:79517-79526. https://doi.org/10.18632/oncotarget.18535

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Abstract

Sung-Hoon Jung1, Je-Jung Lee1, Kihyun Kim2, Cheolwon Suh3, Dok Hyun Yoon3, Chang-Ki Min4, Sang Kyun Sohn5, Chul Won Choi6, Ho Sup Lee7, Hyo Jung Kim8, Ho-Jin Shin9, Soo-Mee Bang10, Sung-Soo Yoon11, Seong Kyu Park12, Ho-Young Yhim13, Min Kyoung Kim14, Jae-Cheol Jo15, Yeung-Chul Mun16, Jae Hoon Lee17, Jin Seok Kim18 and Korean Multiple Myeloma Working Party

1Chonnam National University Hwasun Hospital, Hwasun, Jeollanamdo, Republic of Korea

2Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

3Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

4Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea

5Kyungpook National University Hospital, Daegu, Republic of Korea

6Korea University School of Medicine, Seoul, Republic of Korea

7Kosin University Gospel Hospital, Busan, Republic of Korea

8Hallym University Sacred Heart Hospital, Anyang, Republic of Korea

9Pusan National University Hospital, Busan, Republic of Korea

10Seoul National University Bundang Hospital, Seoul, Republic of Korea

11Seoul National University Hospital, Seoul, Republic of Korea

12Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea

13Chonbuk National University Medical School, Jeonju, Republic of Korea

14Yeungnam University Medical Center, Daegu, Republic of Korea

15Ulsan University Hospital, Ulsan, Republic of Korea

16Ewha Womans University School of Medicine, Seoul, Republic of Korea

17Gachon University Gil Medical Center, Incheon, Republic of Korea

18Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

Correspondence to:

Jin Seok Kim, email: HEMAKIM@yuhs.ac

Keywords: primary plasma cell leukemia, treatment, autologous stem cell transplantation, prognosis

Received: March 24, 2017     Accepted: June 05, 2017     Published: June 16, 2017

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.


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