Wilson Gonsalves, Professor of Medicine, Hematologist, Oncologist at Mayo Clinic, shared a post on LinkedIn:
“Excited to share our latest publication in the American Journal of Hematology examining patterns of progression and outcomes after first relapse in patients with primary plasma cell leukemia (pPCL).
Despite advances in modern myeloma therapy, there remains limited information regarding what happens after pPCL patients experience their first relapse. In this study, we analyzed patients with pPCL treated at Mayo Clinic over nearly two decades to better understand relapse patterns, treatment sequencing, and outcomes after progression.
Key findings:
- The median time to next treatment after frontline therapy was only 10 months, highlighting the aggressive nature of pPCL.
- Patients who developed symptomatic progression had significantly worse outcomes than those with biochemical progression alone, with a median overall survival after progression of just 13 months versus 34 months.
- Response durations became progressively shorter with each subsequent line of therapy, emphasizing the challenges of disease control after relapse.
- Encouragingly, newer targeted and immune-based therapies appeared to provide more durable benefit:
• Patients with t(11;14) disease treated with BCL-2 inhibitor–based approaches achieved prolonged disease control.
• Anti-BCMA CAR-T cell therapy demonstrated particularly promising activity, with a median time to next treatment of 32 months and more than half of treated patients remaining progression-free at last follow-up.
This paper underscores both the continued unmet need in pPCL and the growing promise of precision and cellular therapies for this rare disease. The study also highlights the importance of optimizing treatment sequencing, as many patients experience attrition with successive lines of therapy and may never reach later highly effective treatments.
A special congratulations to first author, Dr. Daniel Packard (Mayo Clinic IM residency) and all of our co-authors who contributed to this work.”
Title: Patterns of Progression and Clinical Outcomes After First Progression in Patients With Primary Plasma Cell Leukemia
Authors: Daniel G. Packard, Shaji K. Kumar, Angela Dispenzieri, Prashant Kapoor, Guneet Janda, Tamer Hellou, Francis K. Buadi, David Dingli, Saurabh Zanwar, Dragan Jevremovic, Suzanne R. Hayman, Nelson Leung, Joselle Cook, Nadine Abdallah, Moritz Binder, Eli Muchtar, Rahma Warsame, Taxiarchis V. Kourelis, Ronald S. Go, Mustaqeem Siddiqui, Lisa Christenson, Miriam Hobbs, Amie Fonder, Karen Pak, Lee H. Lee, Yi Lin, Morie A. Gertz, S. Vincent Rajkumar, Wilson I. Gonsalves
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