Primary PCL: study identifies independent predictors of survival

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Takeaway

  • For patients with primary plasma cell leukemia (pPCL), outcomes may be optimized through upfront autologous stem cell transplantation (ASCT) and novel approaches including proteasome inhibitors and immunomodulators.

Why this matters

  • Data are limited regarding clinical characteristics and outcomes in patients with PCL.

Study design

  • Multicenter study to investigate clinical characteristics, outcomes, and prognostic factors in 117 patients with pPCL.
  • Median age: 61 years (range, 27-85 years).
  • Funding: None disclosed.

Key results

  • 50 months (95% CI, 33-76 months) median follow-up.
  • 78% overall response rate.
  • 21% complete response, 22% very good partial response, 36% partial response, and 22% no response.
  • 35 months (95% CI, 24.3-46 months) median OS in patients who received upfront ASCT vs 13 months (95% CI, 6.3-35.8 months) in patients who did not (Log-rank P<.001).
  • 3 independent predictors of inferior survival were identified in multivariate analyses: age ≥60 years, platelet count ≤100×109/L, and peripheral blood plasma cell count ≥20×109/L.
  • 46 months (95% CI, 33-not reached) median OS in patients with no independent predictors, 27 months (95% CI, 14-41 months) with 1 independent predictor, and 12 months with 2-3 independent predictors (95% CI, 6-20 months).

Limitations

  • Retrospective data.