Leukaemic Transformation of Multiple Myeloma in Post Chemotherapy Remission Phase
Published: April 1, 2016 | DOI: https://doi.org/10.7860/JCDR/2016/.7696
Palak Agarwal, Prachi Nayak, Premala Anthony Singh, Bal Krishna Mishra
1. Department of Pathology, Kriti Scanning Centre Pvt Ltd, Allahabad, India.
2. Department of Pathology, Anoop Labs Pvt Ltd, Allahabad, India.
3. Department of Pathology, Anoop Labs Pvt Ltd, Allahabad, India.
4. Department of Medicine, Kriti Scanning Centre Pvt Ltd, Allahabad, India.
Correspondence
Dr. Palak Agarwal,
55-B, Lowther Road, Near Medical College Allahabad-211001, India.
E-mail: palak_aga3@yahoo.com
Plasma cell leukaemia is diagnosed when plasma cells are >20% in the peripheral blood. Plasma cell leukaemia may be present at the time of diagnosis (primary plasma cell leukaemia) or may evolve from multiple myeloma (secondary plasma cell leukaemia). We report case of a 62-year-old male who was diagnosed with multiple myeloma. He was treated with combination of prednisolone, melphalan and thalidomide. After 6 years he had Worsening of symptoms and also developed a scalp swelling. The swelling was diagnosed as plasmacytoma on fine needle aspiration cytology and confirmed on histopathology. Complete haemogram showed-Haemoglobin - 8g/dl, Total Leucocyte Count – 4300/µl, Differential leucocyte count - Neutrophil-40%, Lymphocyte-28%, Eosinophil-01%, Monocyte-10%, Atypical cells-21%, Platelet count- 1.5 lacs/µl. Peripheral blood showed rouleaux formation and plasma cells. Serum protein electrophoresis revealed an M spike (3.26 g/dl). So, patient was diagnosed as secondary plasma cell leukaemia. Weekly bortezomib and dexamethasone combination chemotherapy was given to the patient. Patient is on monthly follow up. Here we present a detailed case history of this patient.
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