ORIGINAL RESEARCH article
Front. Oncol.
Sec. Hematologic Malignancies
This article is part of the Research TopicBCL-2 Family Inhibitors in Hematologic MalignanciesView all 11 articles
Survival Improvement in Primary Plasma Cell Leukemia: A Retrospective Analysis of Novel Agent-Based Regimens and Stem Cell Transplantation
Provisionally accepted
- Nanjing Drum Tower Hospital, Nanjing, China
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Background: This study aimed to characterize the clinical profile and treatment outcomes of primary plasma cell leukemia (pPCL) patients, defined by ≥5% circulating plasma cells (CPCs) on peripheral blood smear, who received novel agent-based induction therapy. Methods: A retrospective analysis of 46 pPCL patients treated at Nanjing Drum Tower Hospital from March 2014 to April 2025 was conducted. Their clinical and laboratory manifestations, prognostic factors, and efficacy of induction therapies were focused upon. Results: Advanced-stage disease predominated in our cohort. The most frequent cytogenetic abnormalities were chromosome 1q21+ and del(13q14). Failure to achieve ≥very good partial response (VGPR) after first-line therapy independently predicted inferior overall survival (OS) (HR=0.095, 95%CI 0.022-0.421, p=0.002) and shorter median time to next therapy (TTNT) (HR=0.088, 95%CI 0.024-0.329, p<0.001). Intensified regimens combining proteasome inhibitors (PIs)/immunomodulatory drugs (IMiDs) with venetoclax (Ven) significantly improved ≥VGPR rates, particularly when followed by autologous stem cell transplantation (ASCT), prolonged median OS. Conclusion: Despite novel agents, pPCL maintains poor prognosis, with treatment failure strongly associated with suboptimal first-line response. Therapeutic intensification through PIs/IMiDs with Ven (guided by t(11;14)) and ASCT consolidation may enhance depth of remission and survival outcomes.
Keywords: Autologous stem cell transplantation, Primary plasma cell leukemia, prognostic factors, treatment response, venetoclax
Received: 17 Oct 2025; Accepted: 16 Dec 2025.
Copyright: © 2025 Xu, He, Chen, Liu, MIN, Chen and Bai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hua Bai
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