OVERVIEW
Overview of plasma cell leukemia
Plasma cell leukemia is a rare malignant clonal disorder of plasma cells characterized by plasmacytosis, which can be divided into primary plasma cell leukemia and secondary plasma cell leukemia, which develops mainly from multiple myeloma.
Whether medical insurance
yes
Department
Hematology, Medical Oncology
Clinical symptoms
Fever, malaise, bleeding, enlarged liver and spleen, bone pain, renal insufficiency, etc.
Hazards
Patients with this disease are in poor general condition, accompanied by multiple organ function impairment.
Examination
Physical examination, blood routine, blood smear, liver and kidney function tests, bone marrow smear, immunophenotyping, chromosome, fusion gene, gene mutation screening, immunological examination, X-ray film.
Diagnosis
Diagnosis is based on medical history, fever, bone pain and blood smear, bone marrow smear, immunologic examination.
Treatment principle
Comprehensive treatment with chemotherapy and hematopoietic stem cell transplantation.
Curability
Survival period of this disease is short, with active treatment, some patients can improve their symptoms.
Dietary recommendations
High protein, high vitamin, easy to digest food.
Causes
Etiology
Not yet clear.
Symptoms and Diagnosis
Typical Symptoms
Primary plasma cell leukemia has a rapid onset and usually does not have the prodromal symptoms of multiple myeloma disease, such as fatigue, lethargy, hepatosplenomegaly, and enlarged lymph nodes, etc. Secondary plasma cell leukemia mostly has the advanced manifestations of multiple myeloma, including fever, fatigue, bone pain, and in some patients, hepatosplenomegaly is obvious, and there may be a tendency to hemorrhage, with the appearance of skin petechiae or ecchymoses. In contrast, extramedullary infiltration is more common in primary plasma cell leukemia, including hepatosplenomegaly and enlarged lymph nodes, while anemia and bleeding symptoms are more obvious in secondary plasma cell leukemia.
Diagnostic basis
1. Patients have a history of multiple myeloma, or present with fever, malaise, hepatosplenomegaly, bone pain, etc. without any triggers; 2. Peripheral blood plasma cell count rises, and there is often a decrease in red blood cell count and platelet count; 3. Most of the bone marrow hyperplasia is active, which manifests itself as a diffuse infiltration of plasma cells, with progenitor plasma cells and juvenile plasma cells predominantly present; 4. Immunological examination shows that there are monoclonal immunoglobulin heavy and light chains in the serum, and about Half of them are IgG; 5. X-rays of patients with secondary plasma cell leukemia often show osteoporosis.
Treatment
Treatment guidelines
A combination of chemotherapy and hematopoietic stem cell transplantation is used.
Radiotherapy
Chemotherapy is often used as induction therapy before hematopoietic stem cell transplantation.
Surgery
Autologous or allogeneic hematopoietic stem cell transplantation is an effective treatment for this disease, but carries significant risks.
Prognosis
The disease is very aggressive and has a poor prognosis with a short patient survival.
Questions you may be concerned about
What are the latest treatments for plasma cell leukemia?
There is no latest treatment for plasma cell leukemia, and the conventional clinical treatment is still with drugs, chemotherapy, hematopoietic stem cell transplantation and other treatments.
1. Drug therapy: Usually, various drugs can be applied under doctor’s guidance, such as vincristine, cyclophosphamide, prednisone, erythromycin, desmethoxymethyl erythromycin and so on, and some plasma cell leukemia patients can choose etoposide, cisplatin, cytarabine and so on.
2. Chemotherapy: chemotherapy program is generally chosen is VAD program, that is, the use of adriamycin, dexamethasone, thalidomide and other treatment of multiple myeloma program to control the condition. For patients with bone destruction, zoledronic acid can be used for treatment, and some patients may even have bone repair.
3. Hematopoietic stem cell transplantation: i.e. the transplantation of allogeneic hematopoietic stem cells. When performing the transplantation, attention should be paid to the problems of whether there are secondary serious infections and the susceptibility to graft immunity host after bone marrow transplantation. Apply high doses of drugs such as Marfan. Radiation therapy can be performed when available.
Patients with plasma cell leukemia should go to the hospital in time if they have symptoms such as dizziness, fatigue, pallor, etc., and carry out standardized treatment under the guidance of doctors. Daily life should be light, do not eat spicy and stimulating food.
Nursing care
Daily care
1. Keep the environment clean and hygienic and the patient’s body clean to prevent the spread of bacteria in the body, do a good job in oral care, perineum and anus care, and prevent all kinds of infections.2. Use medication according to the doctor’s instructions, adhere to the regular use of medication, and regular outpatient rechecking.3. Patients should learn to self-adjustment of the mind, and learn to confide in the patient; family members should understand and support the patient, and learn to listen to the patient; and if necessary, they should seek the help of professionals to avoid accidents.4. Patients should brush their teeth with a soft-bristled toothbrush and avoid picking teeth with toothpicks.
Diet regulation
High-protein, high-vitamin, easy-to-digest diet; chew and swallow slowly when eating to avoid damage to the oral mucosa.