Abstract

PLASMA CELL LEUKAEMIA: A CASE REPORT AND REVIEW OF LITERATURE

Olaniyi J.A.* and Adeoye O.A.*

Abstract

Plasma cell leukaemia (PCL), a variant of multiple myeloma, is characterized by high levels of circulating plasma cells (PCs) in peripheral blood. It is very rare, very aggressive in nature and hence characterized by poor outcome. This is a case report of a 68-year-old man who presented to us after two years of being managed for back pain with analgesics in a peripheral facility and found to have anaemia, hypercalcaemia and renal failure. The plasma cells count in peripheral blood in absolute terms of (6.480 x109/L) was greater than 2 x 109/L and equally >20% (24%) of total white cell count. The bone marrow showed heavy infiltration of about 90% of abnormal plasma cells. This is the first documented case of PCL in this tertiary hospital and only adds to 2 cases (0.05%) of haematological malignancies documented in a ten year review at University of Ilorin, Nigeria in 2008. The overall presentation of this case is more in keeping with secondary PCL than primary PCL. Also the aggressive nature and poor prognosis of the disease was well demonstrated because the patient succumbed to the disease within one month of therapy. PCL is an aggressive disease with many important differentials. It’s occurrence in this 68 year old is associated with very poor outcome especially in resource poor Countries like ours where late presentation is common and prompt intervention with bortezomib based chemotherapy with/out ASCT remains very difficult to achieve.

Keywords: Plasma cell leukaemia; peripheral smear; bone marrow; monoclonal IgG; renal failure; hypercalcaemia, bone disease.