Plasma cell Leukaemia

Abstract

Patients (11) with plasma cell leukemia (PCL) are reported. Diagnostic clinical, hematological, immunological, biochemical and transmission electron microscopical (TEM) data were analyzed and compared to the largest series of PCL cases reported in the literature. Special attention was paid to the clinical picture at admission, the frequency of PCL, the production of M [monoclonal immunoglobulin] components in relation to the maturity and type of the asynchronous plasma cells, and the diagnostic problems of this entity of acute leukemia of the afferent limb of the B [bone marrow-derived] lymphocyte transformation. PCL was a distinct clinical entity: patients were severely anemic, hepatosplenomegaly was prominent, bone lesions were uncommon but if present were usually nonosteolytic, and the response to treatment with an alkylating agent and glucocorticoid was poor. The diagnosis was difficult as the morphology of circulating plasma cells sometimes required TEM examination. If the peripheral blood of cases of acute leukemias and immunocytic dyscrasias is routinely examined by TEM, PCL appears to be a not uncommon variant of plasma cell dyscrasia; in the present study it was 11%.