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Primary plasma cell leukemia (PPCL) is a rare form of multiple myeloma with a dismal prognosis. This retrospective multi-center study examines the national experience of PPCL in the era of novel agents. During 2002–2016, thirty-nine patients with PPCL were identified in 11 Israeli centers. One-fifth of them died in the first 2 months after diagnosis. The overall survival (OS) of those who survived the first 3 months was 22.5 months. About 70% of patients received at least one type of immunomodulatory drug (IMiD) and similarly proteasome inhibitor (PI) during treatment. There was a survival advantage for those who received IMiD but not for those who received PI or other type of standard dose chemotherapy. In multivariate analysis, low performance status and increased uric acid were also associated with shorter OS. In conclusion, this study demonstrates favorable impact of treatment with IMiDs and hematopoietic cell transplantation on the survival of PPCL patients. [ABSTRACT FROM AUTHOR]

Very little is known about secondary acute lymphoblastic leukaemia (s- ALL). This retrospective analysis studied a cohort of s- ALL patients treated at a single centre between 1994 and 2013, while comparing therapy-associated ALL (t- ALL) and antecedent malignancy ALL (am- ALL) patients. Thirty-two patients with s- ALL were identified. The overall incidence was 9·4% among ALL adults while T-cell s- ALL was rare (12% of s- ALLs). The median time interval between two malignant diagnoses was 5·3 years (range: 0·1-28). In contrast to previous reports, most of the s- ALLs were CD10 + and without KMT2A ( MLL) abnormalities. The overall survival ( OS) rates of the entire cohort at 12 and 24 months from ALL diagnosis was 49% and 25%, respectively. Most patients ( n = 23, 72%) received prior chemo-/radio-therapy for their first malignancy (t- ALL) and only 9 (28%) did not (am- ALL). No significant difference was found in the incidence of B-/T- lineage ALL, extramedullary disease, blood count, and the rate of Philadelphia-positive ALL, nor in the rates of complete remission ( P = 0·55) and OS ( P = 0·97). This similarity, together with high incidence of family malignancy in both groups, raise the possibility that s- ALL patients may have an inherent predisposition to malignancies and a history of previous therapy may be of lesser importance in the pathogenesis of s- ALL. [ABSTRACT FROM AUTHOR]

No abstract available [ABSTRACT FROM AUTHOR]

Abstract: Hyperleukocytosis, arbitrarily defined in acute leukemia as a white blood cell count greater than 100,000/mL, often is associated with increased morbidity and mortality in patients with leukemic processes. It can induce leukostasis, tumor lysis syndrome and disseminated intravascular coagulopathy and has significant prognostic implications with or without one of these clinical complications. The main sites that tend to be injured from the obstructions are the central nerve system and lungs. Despite characteristic clinical presentations, the diagnosis of leukostasis is rarely made with high confidence. The main goal of the management of hyperleukocytosis and/or leukostasis is to reduce the white blood cell count before starting induction chemotherapy. The cytoreduction can be achieved by either leukapheresis and/or hyroxyurea. The technical aspects, complications and efficacy of leukapheresis are discussed in the current article. [Copyright &y& Elsevier]