Plasma Cell Leuk

Question 1

Dx

Answer 1

i) for a blood leukocyte count exceeding 10×109/L, at least 2×109/L are circulating plasma cells, or
(ii) for a peripheral blood leukocyte count below 10×109/L, at least 20% of the circulating cells must be plasma cells.

Question 2

Which flow markers are expressed differently in PCM

Answer 2

CD9, HLADR, CD117, and CD20

Question 3

Lack or weak,e/ o this molecule characteristic of pcl

Answer 3

Cd 56

Question 4

2 forms plc

Answer 4

Primary

Secondary- leukaemia transformation of mm

Question 5

B m microenvironment

Answer 5

Altogether, this suggests that nonhyperdiploid tumors are less dependent on the BM microenvironment than hyperdiploid tumors.

Question 6

Most prev translocation ppl

Answer 6

T11:14

Question 7

Which poor risk chromosomal abnormalities more common in pcm

Answer 7

del(17p)
del(13q)
del(1p21)
ampl(1q21), 
MYC translocations or amplifications
Activating nras kras mutation

Question 8

Clinical differences between mm and pcl

Answer 8

Extramedullary involvement, such as hepatomegaly, splenomegaly, lymphadenopathy, leptomeningeal infiltration, or extramedullary plasmacytomas, is more frequent in pPCL, with extensive bone disease being more common in patients with MM.

Question 9

Reason for change in flow in pcl

Answer 9

Both increased expression of CD20 and CD23 and down-regulation of CD56 may be related to the high incidence of t(11;14) in pPCL

Question 10

Immunophwnotype of pcm

Answer 10

pPCL tumor cells are less often positive for CD56, CD71, CD117, and HLA-DR, but more likely express CD20, CD45, CD19, CD27, and CD23

Question 11

Focus of FISH in pcl

Answer 11

del(17p13), del(13q), del(1p21), ampl(1q21), and the presence of 14q32 abnormalities (t(11;14)t(4;14)and t(14;16)

Question 12

Prognostic factors in pcl

Answer 12

low serum albumin,51 
elevated β2-microglobulin,
hypercalcemia
elevated serum LDH
advanced age
worse performance status
 increased percentage of S-phase plasma cells.
Response to treatment is also of great prognostic value- The failure of blood plasma cells to decline by 50% within 10 days or to be cleared within 4 weeks has been proposed as a criterion identifying patients with unresponsive disease.8