Difference between revisions of "Plasma cell leukemia"

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=Guidelines=
 
=Guidelines=
 
==EMN==
 
==EMN==
*'''2018:''' Gavriatopoulou et al. [https://doi.org/10.1038/s41375-018-0209-7 European myeloma network recommendations on diagnosis and management of patients with rare plasma cell dyscrasias] [https://pubmed.ncbi.nlm.nih.gov/30038381 PubMed]
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*'''2018:''' Gavriatopoulou et al. [https://doi.org/10.1038/s41375-018-0209-7 European myeloma network recommendations on diagnosis and management of patients with rare plasma cell dyscrasias] [https://pubmed.ncbi.nlm.nih.gov/30038381/ PubMed]
 
==IMWG==
 
==IMWG==
 
*'''2012:''' de Larrea et al. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4112539/ Consensus Statement on Diagnostic Requirements, Response Criteria, and Treatment Recommendations by the International Myeloma Working Group (IMWG)]
 
*'''2012:''' de Larrea et al. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4112539/ Consensus Statement on Diagnostic Requirements, Response Criteria, and Treatment Recommendations by the International Myeloma Working Group (IMWG)]

Revision as of 13:19, 26 April 2023

Section editor
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Andrew J. Cowan, MD
University of Washington
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4 regimens on this page
4 variants on this page


Guidelines

EMN

IMWG

First-line therapy

PAD/VCD

PAD/VCD: PS-341 (Bortezomib), Adriamycin liposomal (Pegylated liposomal doxorubicin), Dexamethasone alternating with Velcade (Bortezomib), Cyclophosphamide, Dexamethasone

Regimen

Study Dates of enrollment Evidence
Royer et al. 2016 2010-04 to 2013-07 Phase 2

Targeted therapy

Chemotherapy, PAD portion

Chemotherapy, VCD portion

Glucocorticoid therapy

21-day cycle for 4 cycles

Subsequent treatment

References

  1. Royer B, Minvielle S, Diouf M, Roussel M, Karlin L, Hulin C, Arnulf B, Macro M, Cailleres S, Brion A, Brechignac S, Belhadj K, Chretien ML, Wetterwald M, Chaleteix C, Tiab M, Leleu X, Frenzel L, Garderet L, Choquet S, Fuzibet JG, Dauriac C, Forneker LM, Benboubker L, Facon T, Moreau P, Avet-Loiseau H, Marolleau JP; IFM. Bortezomib, Doxorubicin, Cyclophosphamide, Dexamethasone Induction Followed by Stem Cell Transplantation for Primary Plasma Cell Leukemia: A Prospective Phase II Study of the Intergroupe Francophone du Myélome. J Clin Oncol. 2016 Jun 20;34(18):2125-32. Epub 2016 Apr 25. link to original article contains dosing details in manuscript PubMed EudraCT 2009-016607-33

Lenalidomide & Dexamethasone (Rd)

Rd: Revlimid (Lenalidomide) & low-dose dexamethasone
RevDex: Revlimid (Lenalidomide) & Dexamethasone
Ld: Lenalidomide & low-dose dexamethasone
LenDex: Lenalidomide & Dexamethasone

Regimen

Study Dates of enrollment Evidence
Musto et al. 2013 2009-03-01 to 2011-05-31 Phase 2

Targeted therapy

Glucocorticoid therapy

28-day cycle for 4 cycles

Subsequent treatment

  • Musto et al. 2013, responding patients eligible for transplant: HSCT per center protocol
  • Musto et al. 2013, responding patients ineligible for transplant: Rd x 4 (8 cycles total), then lenalidomide maintenance

References

  1. Musto P, Simeon V, Martorelli MC, Petrucci MT, Cascavilla N, Di Raimondo F, Caravita T, Morabito F, Offidani M, Olivieri A, Benevolo G, Mina R, Guariglia R, D'Arena G, Mansueto G, Filardi N, Nobile F, Levi A, Falcone A, Cavalli M, Pietrantuono G, Villani O, Bringhen S, Omedè P, Lerose R, Agnelli L, Todoerti K, Neri A, Boccadoro M, Palumbo A. Lenalidomide and low-dose dexamethasone for newly diagnosed primary plasma cell leukemia. Leukemia. 2014 Jan;28(1):222-5. Epub 2013 Aug 20. link to original article contains dosing details in manuscript PubMed

Consolidation after first-line therapy

Melphalan, then auto HSCT

Regimen

Study Evidence
Royer et al. 2016 Phase 2

Preceding treatment

Chemotherapy

  • Melphalan (Alkeran) IV once (day not specified) by the following age- and laboratory-based criteria:
    • 65 or younger with CrCl of 30 mL/min/1.73m2 or greater: 200 mg/m2
    • Patients older than 65 years or with CrCl less than 30 mL/min/1.73m2: 140 mg/m2

References

  1. Royer B, Minvielle S, Diouf M, Roussel M, Karlin L, Hulin C, Arnulf B, Macro M, Cailleres S, Brion A, Brechignac S, Belhadj K, Chretien ML, Wetterwald M, Chaleteix C, Tiab M, Leleu X, Frenzel L, Garderet L, Choquet S, Fuzibet JG, Dauriac C, Forneker LM, Benboubker L, Facon T, Moreau P, Avet-Loiseau H, Marolleau JP. Bortezomib, Doxorubicin, Cyclophosphamide, Dexamethasone Induction Followed by Stem Cell Transplantation for Primary Plasma Cell Leukemia: A Prospective Phase II Study of the Intergroupe Francophone du Myélome. J Clin Oncol. 2016 Jun 20;34(18):2125-32. Epub 2016 Apr 25. link to original article contains dosing details in abstract PubMed EudraCT 2009-016607-33

Maintenance after first-line therapy

Lenalidomide monotherapy

Regimen

Study Evidence
Musto et al. 2013 Phase 2

Preceding treatment

Targeted therapy

28-day cycles

References

  1. Musto P, Simeon V, Martorelli MC, Petrucci MT, Cascavilla N, Di Raimondo F, Caravita T, Morabito F, Offidani M, Olivieri A, Benevolo G, Mina R, Guariglia R, D'Arena G, Mansueto G, Filardi N, Nobile F, Levi A, Falcone A, Cavalli M, Pietrantuono G, Villani O, Bringhen S, Omedè P, Lerose R, Agnelli L, Todoerti K, Neri A, Boccadoro M, Palumbo A. Lenalidomide and low-dose dexamethasone for newly diagnosed primary plasma cell leukemia. Leukemia. 2014 Jan;28(1):222-5. Epub 2013 Aug 20. link to original article contains dosing details in manuscript PubMed