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ctt-journal > Anikina et al. (Abstract)

Anikina et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 12
doi: 10.3205/ctt-2011-No12-abstract26

© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "5th Raisa Gorbacheva Memorial Meeting Hematopoietic Stem Cell Transplantation in Children and Adults", Saint Petersburg, Russia, September 18–20, 2011

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A case report of extramedullary relapse of plasma cell leukemia after autologous hematopoietic stem cell transplantation

Ekaterina V. Anikina, Tatyana I. Ksenzova

Tyumen Regional Clinical Hospital, Tyumen, Russia

Correspondence: Ekaterina V. Anikina, Tyumen Regional Clinical Hospital, 55, Kotovskogo str., 625003, Tyumen, Russia, E-mail: evanikina@spam is badmail.ru

Abstract

The patient S., female, aged 59 with plasma cell leukemia was observed in Tyumen. PAD treatment protocol resulted in a complete remission. Autologous hematopoietic stem cell transplantation was performed at the Hematological Research Center RAMS (Moscow). Immunochemical remission was confirmed. The patient received bortezomib therapy between treatment stages. The patient remained in complete remission at 4 months after transplantation. Deterioration of health developed at 11 months after transplantation in the form of ptosis of the left eyelid, strabismus, and headache. The differential diagnosis included neuroleukemia, polyneuropathy, viral and tuberculosis brain infections, and brain tumor. None of these diagnoses were proven. A bone marrow examination and immunochemical study indicated remission of plasma cell leukemia. Neurological symptoms progressed with development of ptosis of the right eyelid, decreased visual acuity and optic nerve atrophy, dysphagia, pelvic organ dysfunction, and severe pain syndrome. Repeated lumbar punctures revealed cytosis up to 116 cells per microliter (lymphocytes 43%, plasma cells 4%). An immunophenotypic study of cerebrospinal fluid (CSF) cells confirmed plasma cell neuroleukemia (CD38+CD138+CD58+).

Thus a rare variant of extramedullary relapse with central nervous system involvement was ascertained. Intrathecal chemotherapy and radiotherapy induced a CSF cytosis normalization and short-term clinical improvement.

Keywords: plasma cell leukemia, transplantation, extramedullary relapse, neuroleukemia