Plasma Cell Neoplasm Concomitant with Myeloid Malignancies: Clinicopathological Study of 7 Cases
Deepti M Reddi, Elizabeth L Boswell, Chuanyi M Lu, Endi Wang. Duke University Medical Center, Durham; University of California San Francisco, San Francisco
Background: Plasma cell neoplasm (PCN) has a prolonged clinical course, and secondary malignancies occasionally occur, mostly after treatment for PCN. Rarely does PCN occur concomitant with a myeloid neoplasm (MN). The risk, etiology, pathogenesis and prognosis of this complication have not been well characterized. Here, we report 7 cases of PCN cases concomitant with MNs.
Design: Seven cases of PCM concurrent with or shortly after diagnosis of myeloid disorder were retrieved from our pathology database, and their clinicopathological features were retrospectively evaluated.
Results: Of 7 cases, 5 are male and 2 are female. Patient age at primary diagnosis ranges from 42 to 79 years with median of 66. MNs include essential thrombocythemia (ET) in 1, atypical chronic myeloid leukemia in 1, refractory anemia with ringed sideroblasts (RARS) in 1, refractory anemia with excess blasts (RAEB-1) in 1 and acute myeloid leukemia (AML) in 3 cases. Of these, 4 cases had concomitant PCN and 3 cases was diagnosed with PCN shortly after MN with the latency ranging from 2.5 to 33 months with median of 14. Treatment primarily targeted to MNs. Of 7 cases tested, 3 had clonal cytogenetic abnormalities, all consistent with MN. Six cases had follow up, ranging from 1.5 to 107 months with median of 15.5. Of these, 2 died of disease (AML) progression, 1 died of pancreatic neoplasm, and 4 were alive.
Conclusions: All PCNs were diagnosed simultaneously with or shortly after MNs suggesting concurrency of two neoplasms. The findings may suggest a predisposition to other malignancies in this patient population. Concomitant AML/PCN had a worse prognosis with AML remained as a life threatening component, while concomitant PCN/other MNs may have a relatively protracted clinical course.
Wednesday, March 21, 2012 1:00 PM
Poster Session VI # 222, Wednesday Afternoon