A Systematic Review of Conventional Therapy and Role of Stem Cell Transplantation for Primary Plasma Cell Leukemia

Abstract

When comparing group 4 (median OS >9 years) to the other groups (median OS <9 years), younger age at MM diagnosis, frontline SCT, treatment at a high-volume cancer center, no associated comorbidities, female sex, insured, and median household income were associated with long-term survival in a multivariate analysis. The Table 2 shows univariate and multivariate odds ratio for long-term MM survival. Conclusion: Among patients with MM diagnosed between 2004 and 2006, 1 in 8 patients were long-term survivors (OS > 3X the median). Although differences in the underlying disease biology could not be assessed, key differences in socio-demographic characteristics, patient volume at treatment facility and use of SCT were associated with longterm survival. While some features at MM diagnosis cannot be changed (age, sex, associated comorbidities), early use of SCT and treatment at a high-volume cancer center at the time of diagnosis might impact long-term OS.

Management of Primary Plasma Cell Leukemia Remains Challenging Even in the Era of Novel Agents

“…The median overall survival of PCL patients, before the use of novel agents, was historically measured in only a few months. 14 However, with the incorporation of novel agents (bortezomib, lenalidomide or thalidomide) and autologous HSCT, survival has been reported to improve to 12 months. 15 While this represents favorable progress for this patient group, more improvement is necessary to improve outcomes in the treatment of PCL.…”