Primary plasma cell leukemia: effective treatment with intermediate dose Melphalan

Primary Plasma cell Leukemia (PCL) is a rare disease with no standard treatment, although, combination chemotherapy, BMT and intermediate dose melphalan have been shown to be effective, in some case reports. Patients usually present with anemia, thrombocytopenia, hypercalcemia, and renal failure. Diagnosis is confirmed by peripheral and bone marrow examination. We recently had a case in our department. A 43 years old gentleman presented with history of fatigue, weakness, weight loss, dyspnea and bone pain. Diagnosis of PCL was confirmed by PBS and bone marrow exam. The patient was treated using single intermediate dose melphalan (60 mg/m2/ IV) plus Dexamethasone with G–CSF support after 3 weeks, complete remission was achieved. In the last visit, done 9 months after treatment, he was doing well clinically and his Lab data were normal. This case report confirmed the efficacy of intermediate dose of melphalan in the management of plasma cell leukemia.