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KMID : 1100820230130010036
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Laboratory Medicine Online
2023 Volume.13 No. 1 p.36 ~ p.41
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Therapeutic Leukapheresis for Plasma Cell Leukemia Presenting with Hyperleukocytosis: The First Case in Korea
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Park Soo-Yong
Park Jae-Hyeon
Chung You-Sun
Ko Dae-Hyun
Kim Hyung-Suk
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Abstract
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Plasma cell leukemia (PCL) is a rare plasma cell disorder. Although therapeutic plasma exchange has reportedly been performed for hypergammaglobulinemia in PCL, there are no reports of therapeutic leukapheresis (TL) having been performed for hyperleukocytosis in Korea. Here, we report a rare case of TL performed for hyperleukocytosis in PCL with a literature review. A 78-year-old female patient was diagnosed and treated for non-secretory myeloma 5 years ago before the present visit. She was diagnosed with secondary PCL 6 months ago after which her chemotherapy regimen was changed. The patient developed worsening dyspnea and memory loss one week before admission. She was hospitalized and two sessions of TL were performed to alleviate the symptoms caused by hyperleukocytosis (leukocyte count 335.60×109/L, plasma cell 88%) and leukostasis. Although the leukocytes in peripheral blood were effectively removed (leukocyte count 171.29×109/L, 48% reduction after first TL; leukocyte count 84.53×109/L, 74% reduction after second TL), it was difficult to accurately assess whether the symptoms improved, owing to communication difficulties due to delirium. Although chemotherapy was administered, the patient died of multiple organ failure on the 13th day after admission. This case presented the highest leukocyte count among reports in the existing literature on rare cases of PCL with hyperleukocytosis. Although the patient eventually died, this is the first case of TL performed to successfully decrease leukocytes in PCL in Korea, presenting the potential for delaying the exacerbation of disease progression.
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KEYWORD
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Leukapheresis, Plasma cell leukemia, Leukocytosis, Multiple myeloma
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