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

Title
The role of frontline autologous stem cell transplantation for primary plasma cell leukemia: a retrospective multicenter study (KMM160)
Authors
Jung, Sung-HoonLee, Je-JungKim, KihyunSuh, CheolwonYoon, Dok HyunMin, Chang-KiSohn, Sang KyunChoi, Chul WonLee, Ho SupKim, Hyo JungShin, Ho-JinBang, Soo-MeeYoon, Sung-SooPark, Seong KyuYhim, Ho-YoungKim, Min KyoungJo, Jae-CheolMun, Yeung-ChulLee, Jae HoonKim, Jin SeokKorean Multiple Myeloma Working Pa
Ewha Authors
문영철
SCOPUS Author ID
문영철scopus
Issue Date
2017
Journal Title
ONCOTARGET
ISSN
1949-2553JCR Link
Citation
vol. 8, no. 45, pp. 79517 - 79526
Keywords
primary plasma cell leukemiatreatmentautologous stem cell transplantationprognosis
Publisher
IMPACT JOURNALS LLC
Indexed
SCIE; SCOPUS WOS
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.
DOI
10.18632/oncotarget.18535
Appears in Collections:
의학전문대학원 > 의학과 > Journal papers
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