Primary plasma cell leukaemia. A case report and a review of the literature.

A case history of a patient with primary plasma cell leukaemia is presented. Analysis of serum showed an IgDλ paraprotein, and λ-light-chains were found in the urine. Immunofluorescence studies of a bone marrow aspirate revealed intracytoplas-matic IgD of λ-type in plasma cells. Moreover J-chain could be demonstrated in these plasma cells. A complete remission of the disease, with disappearance of the paraprotein, was obtained following treatment with a combination of cyclophosphamide, vin-cristine and prednisone. 12 months later, the patient developed multiple extramedullary plasmocytoma lesions in the skin. After treatment with cyclophosphamide, vincristine, doxorubicin and prednisone, another remission was achieved. The literature on the clinical features and the response to chemotherapy of primary plasma cell leukemia is reviewed.