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

Authors
 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  ;  Korean Multiple Myeloma Working Party 
Citation
 ONCOTARGET , Vol.8(45) : 79517-79526, 2017 
Journal Title
 ONCOTARGET 
Issue Date
2017
Keywords
autologous stem cell transplantation ; primary plasma cell leukemia ; prognosis ; treatment
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.
Files in This Item:
T201704737.pdf Download
DOI
10.18632/oncotarget.18535
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/161408
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