Secondary plasma cell leukemia.

Plasma cell leukemia (PCL) is a rare disease and is the least common variant of multiple myeloma accounting for 2-3% of all plasma cell dyscrasias. We report a patient who was diagnosed with multiple myeloma, 12 months earlier; he was treated with VBCMP, VCMP regime, and after 12 months he presented of high grade fever, weakness, palpitations, loss of appetite, bone pains, dyspnea. Initial evaluation revealed plasmacytosis with blood plasma cell count of 13 860/mm³. His hemoglobin (Hb) was 8.4 mg/dL, platelets were 45 000/mm³ and total leukocyte count (TLC) was 23 100/mm³ (60% plasma cells). Bone marrow examination revealed 90% plasmablastic cells. Serum LDH was high at 3117 U/L and serum calcium was also elevated at 9.1 mg/dL. A diagnosis of PCL was made and the patient was started on treatment with VAD regime along with supportive care. Patient condition deteriorated very quickly, despite treatment and he died on the third day. A detailed report of this case and a review of PCL is presented here.