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Fulltext Hepatoprotective effect of bone marrow-derived mesenchymal stromal cells in CCl4-induced liver cirrhosis

Aithal AP, Bairy LK, Seetharam RN, Kumar N

3 Biotech, 2021 Feb;11(2):107.
PMID: 33564610 DOI: 10.1007/s13205-021-02640-y

Bone marrow mesenchymal stromal cells (BM-MSCs) are multipotent stem cells which are ideal candidates for use in regenerative medicine. The objectives of this study were to evaluate the hepatoprotective effect of BM-MSC and its combination treatment with silymarin in carbon tetrachloride (CCl4)-induced liver cirrhosis animal model and to investigate whether tail vein or portal vein infusion was the ideal route for BM-MSC transplantation. 36 female Wistar rats were randomly divided into six groups (n = 6): Group 1 (normal control), Group 2 (received only CCl4, disease model), Group 3 (CCl4 + BM-MSCs through tail vein), Group 4 (CCl4 + BM-MSCs through portal vein), Group 5 (CCl4 + silymarin), Group 6 (CCl4 + BM-MSCs + silymarin). On the 21st day after treatment, blood samples were collected for biochemical estimations. After the experiment, the rats were sacrificed. Liver was dissected out and processed for histopathology and scanning electron microscopy studies. Liver enzyme and marker analysis, histopathological studies indicated that the combination of BM-MSCs and silymarin was effective in treating liver cirrhosis. Transplanted BM-MSCs in combination with silymarin ameliorated the liver tissue damage through their immunoregulatory activities. Among the two routes, the intravenous administration of cells through the tail vein was found to be more effective and safe.

Matched MeSH terms: Bone Marrow
Fulltext Histological observation of gingival enlargement induced by cyclosporin a and nifedipine: a study in rabbits

Al-Bayaty, F.H., Al-Tay, B.O., Al-Kushali, S.S., Mahmmod, L.

ASM Science Journal, 2009;3(1):45-50.
MyJurnal

A study was undertaken to estimate the histological changes of gingival enlargement induced by
Cyclosporin A (CsA) and Nifedipine, separately and in combination. Twelve adult rabbits were divided equally into four main groups. The first group received 10 mg/kg/day Nifedipine, the second received 10 mg/kg/day CsA, and the third received a combination of 10 mg/kg /day Nifedipine and CsA by gastric feeding. The fourth was regarded as a control group. Animals were given the drugs from day 1 of the experiment until day 70. They were then sacrificed for histological purposes. Results showed increase in the thickness of the epithelium with keratosis and acanthosis, and also increased vascularity. Collagen fibres and fibroblasts at different rates in the three histological groups were observed. Significant alveolar bone resorption with increased marrow spaces filled with fatty tissue were found in the CsA group. Non-significant changes in the alveolar bone of the Nifedipine group while subsequent bone resorption and bone deposition were seen in the combination group. These changes could be due to the effect of both drugs. Significant changes in the gingiva and the alveolar bone were shown in the three experimental groups compared with the control group.

Matched MeSH terms: Bone Marrow
Autoimmune thrombocytopenia and neutropenia after autologous peripheral blood stem cell transplantation

Wahid FS, Cheong SK, Sivagengei K

Acta Haematol., 2002;107(4):237-8.
PMID: 12053154
Matched MeSH terms: Bone Marrow/pathology
In vivo evidence of all-trans retinoic acid inducing maturation in acute promyelocytic leukaemia

Hamidah HN, Cheong SK, Ainoon O

Acta Haematol., 1993;89(1):50-1.
PMID: 8480488

All-trans retinoic acid therapy induces maturation in acute promyelocytic leukaemia. We document in vivo evidence of differentiation by all-trans retinoic acid in a case of acute promyelocytic leukaemia which was characterized by cytoplasmic vacuolations.

Matched MeSH terms: Bone Marrow/ultrastructure
Fulltext Leukemic phase of ALK-negative anaplastic large cell lymphoma in a patient who is on androgenic steroids: A case report

Kasinathan G

Ann Med Surg (Lond), 2020 Jan;49:1-4.
PMID: 31871676 DOI: 10.1016/j.amsu.2019.11.007

ALK-negative anaplastic large cell lymphoma (ALCL) is a peripheral T-cell lymphoma that usually involves lymph nodes or extranodal sites. Leukemic phase of ALK-negative ALCL is exceedingly rare and often carries a poor prognosis. Androgenic steroids have gained popularity among the young, and at higher doses, it can result in immune dysregulation and may be potentially carcinogenic. Case presentation: A 30-year-old gentleman of Malay ethnicity presented to the hematology department with night fevers, loss of weight and bony pain for the past 6 weeks. He is a gymnasium instructor with a history of chronic usage of intramuscular testosterone enanthate. Physical examination revealed ecchymosis over the left elbow and hepatomegaly. A complete blood count depicted anemia, thrombocytopenia and leucocytosis. An 18-Fluorodeoxyglucose positron emission tomography (18-FDG PET/CT) imaging showed a hypermetabolic anterior mediastinal mass of 6.8 × 7.0 × 6.5 cm with diffuse hypermetabolism in the liver, spleen and axial skeleton. The bone marrow trephine and mediastinal tissue histology were consistent with leukemic ALK-negative ALCL. He was treated with CHOEP (cyclophosphamide, doxorubicin, vincristine, etoposide, prednisolone) induction chemotherapy in which he required intensive antibiotic and blood support. He progressed with worsening B symptoms and new diffuse lymphadenopathies suggesting rapid dissemination of the disease. He subsequently succumbed to multiorgan failure with disseminated intravascular coagulopathy at the intensive care unit. Conclusion: Leukemic phase ALK-negative ALCL often carries a complex karyotype and requires early intensive polychemotherapy. Use of anabolic steroids depletes the ability of defending lymphocytes to remove tumour producing cells.

Matched MeSH terms: Bone Marrow
Viva-Asia Blood and Marrow Transplantation Groups - A Survey of Consortium Activity over a 12-year Period (2000 to 2011)

Tan AM, Ha C, Li CF, Chan GC, Lee V, Tan PL, et al.

Ann Acad Med Singap, 2016 Mar;45(3):106-9.
PMID: 27146463
Matched MeSH terms: Bone Marrow Transplantation/statistics & numerical data
Idiopathic CD4+ T-lymphocytopenia in a child with disseminated cryptococcosis

Menon BS, Shuaib IL, Zamari M, Haq JA, Aiyar S, Noh LM

Ann Trop Paediatr, 1998 Mar;18(1):45-8.
PMID: 9692001

We describe a Malay girl with disseminated cryptococcosis affecting the lungs, liver, lymph nodes and bones. The diagnosis was made by culture of the bone marrow. Tests of immune function showed that she was HIV-negative but the CD4 percentage was persistently low. Idiopathic CD4+ T-lymphocytopenia was diagnosed. The child died despite two courses of anti-fungal therapy.

Matched MeSH terms: Bone Marrow/microbiology
Fulltext Genotoxic evaluation of synthetic hydroxyapatite using mammalian bone marrow chromosome aberration test

Kannan, Thirumulu Ponnuraj, Nik Ahmad Shah Nik Lah, Azlina Ahmad, Siti Fatimah Ramli, Narazah Mohd Yusof, Ab Rani Samsudin

Archives of Orofacial Sciences, 2014;9(1):1-7.
MyJurnal

Some of the beneficial bio compatible properties of hydroxyapatite [Ca10(PO4)6(OH)2]; the major componentand an essential ingredient of normal bone and teeth, are that it is rapidly integrated into the human body and will bondto bone forming in distinguishable unions. But, before new materials are approved for medical use, mutagenesis systems to exclude cytotoxic, mutagenic or carcinogenic properties are applied worldwide. This study aimed to detectany chromosomal aberrations induced by the synthetic hydroxyapatite granules [Manufactured by Universiti Sains
Malaysia, (USM) Penang, Malaysia] in the bone marrow cells of mice. The mitotic indices of the groups treated with synthetic hydroxya patite granules did not show any significant difference as compared to the negative control group treated with distilled water. Also the groups of mice treated with synthetic hydroxyapatite granules and distilled waterdid not induce significant change in chromosome aberrations as compared to the positive control group treated with Mitomycin C. The mitotic indices and chromosomal analyses indicate that under the present test conditions, synthetichydroxya patite granules (manufactured by USM) are non cytotoxic and do not induce chromosome aberrations in the bone marrow cells of mice.

Matched MeSH terms: Bone Marrow Cells
Fulltext Stem cells from childrens' teeth

Mohd Hilmi, A.B., Fazliah, S.N., Siti Fadilah, A., Asma, H., Siti Razila, A.R., Shaharum, S., et al.

Archives of Orofacial Sciences, 2008;3(1):29-31.
MyJurnal

The aim of this study was to isolate stem cells from dental pulp of primary molars and incisors to be used as possible source for tissue engineering. Human primary molars and incisors were collected from subjects aged 4-7 year-old under standardized procedures. Within 24 hours, the tooth was cut at the cemento-enamel junction using hard tissue material cutter. The dental pulp tissue was extracted, digested and then cultured in Alpha Modified Eagles's Medium (α-MEM) supplemented with 20% FCS, 100 mM L-ascorbic acid 2-phosphate, 200 mM L-glutamine and 5000 units/ml Penicillin/Streptomycin. The cells were observed daily under the microscope until confluence. Children's tooth pulp- derived progenitor cells were found positive for stem cell markers CD105 and CD166, which are consistent with the finding for mesenchymal stem cells (MSCs) from bone marrow.

Matched MeSH terms: Bone Marrow
Fulltext Mitochondrial Respiration Is Reduced in Atherosclerosis, Promoting Necrotic Core Formation and Reducing Relative Fibrous Cap Thickness

Yu EPK, Reinhold J, Yu H, Starks L, Uryga AK, Foote K, et al.

Arterioscler Thromb Vasc Biol, 2017 12;37(12):2322-2332.
PMID: 28970293 DOI: 10.1161/ATVBAHA.117.310042

OBJECTIVE: Mitochondrial DNA (mtDNA) damage is present in murine and human atherosclerotic plaques. However, whether endogenous levels of mtDNA damage are sufficient to cause mitochondrial dysfunction and whether decreasing mtDNA damage and improving mitochondrial respiration affects plaque burden or composition are unclear. We examined mitochondrial respiration in human atherosclerotic plaques and whether augmenting mitochondrial respiration affects atherogenesis.
APPROACH AND RESULTS: Human atherosclerotic plaques showed marked mitochondrial dysfunction, manifested as reduced mtDNA copy number and oxygen consumption rate in fibrous cap and core regions. Vascular smooth muscle cells derived from plaques showed impaired mitochondrial respiration, reduced complex I expression, and increased mitophagy, which was induced by oxidized low-density lipoprotein. Apolipoprotein E-deficient (ApoE-/-) mice showed decreased mtDNA integrity and mitochondrial respiration, associated with increased mitochondrial reactive oxygen species. To determine whether alleviating mtDNA damage and increasing mitochondrial respiration affects atherogenesis, we studied ApoE-/- mice overexpressing the mitochondrial helicase Twinkle (Tw+/ApoE-/-). Tw+/ApoE-/- mice showed increased mtDNA integrity, copy number, respiratory complex abundance, and respiration. Tw+/ApoE-/- mice had decreased necrotic core and increased fibrous cap areas, and Tw+/ApoE-/- bone marrow transplantation also reduced core areas. Twinkle increased vascular smooth muscle cell mtDNA integrity and respiration. Twinkle also promoted vascular smooth muscle cell proliferation and protected both vascular smooth muscle cells and macrophages from oxidative stress-induced apoptosis.
CONCLUSIONS: Endogenous mtDNA damage in mouse and human atherosclerosis is associated with significantly reduced mitochondrial respiration. Reducing mtDNA damage and increasing mitochondrial respiration decrease necrotic core and increase fibrous cap areas independently of changes in reactive oxygen species and may be a promising therapeutic strategy in atherosclerosis.

Matched MeSH terms: Bone Marrow Transplantation
Fulltext Carbon Monoxide Suppresses Neointima Formation in Transplant Arteriosclerosis by Inhibiting Vascular Progenitor Cell Differentiation

Sakihama H, Lee GR, Chin BY, Csizmadia E, Gallo D, Qi Y, et al.

Arterioscler Thromb Vasc Biol, 2021 Jun;41(6):1915-1927.
PMID: 33853347 DOI: 10.1161/ATVBAHA.120.315558

[Figure: see text].

Matched MeSH terms: Bone Marrow Transplantation
Articular cartilage regeneration with autologous marrow aspirate and hyaluronic Acid: an experimental study in a goat model

Saw KY, Hussin P, Loke SC, Azam M, Chen HC, Tay YG, et al.

Arthroscopy, 2009 Dec;25(12):1391-400.
PMID: 19962065 DOI: 10.1016/j.arthro.2009.07.011

PURPOSE: The purpose of the study was to determine whether postoperative intra-articular injections of autologous marrow aspirate (MA) and hyaluronic acid (HA) after subchondral drilling resulted in better cartilage repair as assessed histologically by Gill scoring.
METHODS: In a goat model we created a 4-mm full-thickness articular cartilage defect in the stifle joint (equivalent to 1.6 cm in the human knee) and conducted subchondral drilling. The animals were divided into 3 groups: group A (control), no injections; group B (HA), weekly injection of 1 mL of sodium hyaluronate for 3 weeks; and group C (HA + MA), similar to group B but with 2 mL of autologous MA in addition to HA. MA was obtained by bone marrow aspiration, centrifuged, and divided into aliquots for cryopreservation. Fifteen animals were equally divided between the groups and sacrificed 24 weeks after surgery, when the joint was harvested, examined macroscopically and histologically.
RESULTS: Of the 15 animals, 2 from group A had died of non-surgery-related complications and 1 from group C was excluded because of a joint infection. In group A the repair constituted mainly scar tissue, whereas in group B there was less scar tissue, with small amounts of proteoglycan and type II collagen at the osteochondral junction. In contrast, repair cartilage from group C animals showed almost complete coverage of the defect with evidence of hyaline cartilage regeneration. Histology assessed by Gill scoring was significantly better in group C with 1-way analysis of variance yielding an F statistic of 10.611 with a P value of .004, which was highly significant.
CONCLUSIONS: Postoperative intra-articular injections of autologous MA in combination with HA after subchondral drilling resulted in better cartilage repair as assessed histologically by Gill scoring in a goat model.
CLINICAL RELEVANCE: After arthroscopic subchondral drilling, this novel technique may result in better articular cartilage regeneration.

Matched MeSH terms: Bone Marrow Transplantation/methods*
Whole-Exome Sequencing of ETV6/RUNX1 in Four Childhood Acute Lymphoblastic Leukaemia Cases

Zakaria Z, Othman N, Ismail A, Kamaluddin NR, Esa E, Abdul Rahman EJ, et al.

Asian Pac J Cancer Prev, 2017 04 01;18(4):1169-1175.
PMID: 28548470

Background: ETV6/RUNX1 gene fusion is the most frequently seen chromosomal abnormality in childhood acute
lymphobastic leukamia (ALL). However, additional genetic changes are known to be required for the development of
this type of leukaemia. Therefore, we here aimed to assess the somatic mutational profile of four ALL cases carrying the
ETV6/RUNX1 fusion gene using whole-exome sequencing. Methods: DNA was isolated from bone marrow samples
using a QIAmp DNA Blood Mini kit and subsequently sequenced using the Illumina MiSeq system. Results: We
identified 12,960 to17,601 mutations in each sample, with a total of 16,466 somatic mutations in total. Some 15,533
variants were single nucleotide polymorphisms (SNPs), 129 were substitutions, 415 were insertions and 389 were
deletions. When taking into account the coding region and protein impact, 1,875 variants were synonymous and 1,956
were non-synonymous SNPs. Among non-synonymous SNPs, 1,862 were missense, 13 nonsense, 35 frameshifts, 11
nonstop, 3 misstart, 15 splices disrupt and 17 in-frame indels. A total of 86 variants were located in leukaemia-related
genes of which 32 variants were located in the coding regions of GLI2, SP140, GATA2, SMAD5, KMT2C, CDH17,
CDX2, FLT3, PML and MOV10L1. Conclusions: Detection and identification of secondary genetic alterations are
important in identifying new therapeutic targets and developing rationally designed treatment regimens with less
toxicity in ALL patients.

Matched MeSH terms: Bone Marrow
Quantitative Proteomics Analysis Revealed Compromised Chicken Dendritic Cells Function at Early Stage of Very Virulent Infectious Bursal Disease Virus Infection

Yasmin AR, Omar AR, Farhanah MI, Hiscox AJ, Yeap SK

Avian Dis, 2019 06 01;63(2):275-288.
PMID: 31251527 DOI: 10.1637/11936-072418-Reg.1

Chicken dendritic cells (DCs) have been demonstrated to be susceptible to infectious bursal disease virus (IBDV), a causative agent of acute and immunosuppressed disease in young chicks known as infectious bursal disease. Further functional characterization of IBDV-infected DCs of chickens is required to provide a better understanding on the influence of the virus on chicken bone marrow-derived dendritic cells (BM-DCs) following very virulent (vv) IBDV infection. Membrane proteins of BM-DCs were extracted and the proteins were further denatured and reduced before performing labeling with isobaric tags for relative and absolute quantitation. The differential expression protein profiles were identified and quantified using liquid chromatography coupled with tandem mass spectrometry, and later validated using flow cytometry and real-time reverse transcriptase PCR. The analysis has identified 134 differentially regulated proteins from a total of 283 proteins (cutoff values of ≤0.67, ≥1.5, and ProtScore >1.3 at 95% confidence interval), which produced high-yield membrane fractions. The entry of vvIBDV into the plasma membrane of BM-DCs was observed at 3 hr postinfection by the disruption of several important protein molecule functions, namely apoptosis, RNA/DNA/protein synthesis, and transport and cellular organization, without the activation of proteins associated with signaling. At the later stage of infection, vvIBDV induced expression of several proteins, namely CD200 receptor 1-A, integrin alpha-5, HSP-90, cathepsin, lysosomal-associated membrane protein, and Ras-related proteins, which play crucial roles in signaling, apoptosis, stress response, and antigen processing as well as in secretion of danger-associated proteins. These findings collectively indicated that the chicken DCs are expressing various receptors regarded as potential targets for pathogen interaction during viral infection. Therefore, fundamental study of the interaction of DCs and IBDV will provide valuable information in understanding the role of professional antigen-presenting cells in chickens and their molecular interactions during IBDV infection and vaccination.

Matched MeSH terms: Bone Marrow
Nucleotide sequence and phylogenetic analysis of Newcastle disease virus isolates from recent outbreaks in Taiwan

Yang CY, Chang PC, Hwang JM, Shieh HK

Avian Dis, 1997 Apr-Jun;41(2):365-73.
PMID: 9201401

Portions of the hemagglutinin neuraminidase (HN) gene of Newcastle disease virus (NDV) isolates from two recent outbreaks were sequenced to investigate epidemiology of this disease in Taiwan. These NDV isolates were all viscerotropic velogenic according to the clinical lesions produced in chickens. Sequence data were obtained from 14 NDV isolates (12 from 1995 and 2 from 1984). All isolates differed in their nucleotide sequences (from 0.3 to 15.3%), and represented potentially different strains of NDV. Phylogenetic analysis revealed that these isolates are closely related to viruses isolated from Japan and Malaysia. Some viruses isolated in 1995 appeared to evolve from viruses isolated in 1984. The results suggest that the 1995 outbreak of Newcastle disease (ND) in Taiwan may have been caused by multiple strains of velogenic NDV that have cocirculated in Taiwan for some time. Moreover, NDV isolates from racing pigeons were very similar to isolates from chickens in the same period, suggesting that both domestic and free-living birds were involved in the spread of ND in Taiwan.

Matched MeSH terms: Bone Marrow/pathology
In vitro characterization of chicken bone marrow-derived dendritic cells following infection with very virulent infectious bursal disease virus

Yasmin AR, Yeap SK, Tan SW, Hair-Bejo M, Fakurazi S, Kaiser P, et al.

Avian Pathol, 2015;44(6):452-62.
PMID: 26305169 DOI: 10.1080/03079457.2015.1084997

Infectious bursal disease is caused by infectious bursal disease virus (IBDV), an immunosuppressive virus that targets immune cells such as B cells and macrophages. However, the involvement of dendritic cells (DCs) during IBDV infection is not well understood. In this study the in vitro effects of live and inactivated very virulent IBDV (vvIBDV) UPM0081 on bone marrow-derived DCs (BM-DC) were characterized and compared with BM-DC treated with lipopolysaccharide (LPS). Morphologically, BM-DC treated with LPS and vvIBDV showed stellate shape when compared to immature BM-DC. In addition, LPS-treated and both live and inactivated vvIBDV-infected BM-DC expressed high levels of double positive CD86 and major histocompatibility complex class II antigens (>20%). vvIBDV-infected BM-DC showed significantly higher numbers of apoptotic cells compared to LPS. Replication of vvIBDV was detected in the infected BM-DC as evidenced by the increased expression of VP3 and VP4 IBDV antigens based on flow cytometry, real-time polymerase chain reaction and immunofluorescence tests. Levels of different immune-related genes such as interleukin-1β (IL-1β), CXCLi2 (IL-8), IL-18, interferon gamma (IFN-γ, IL-12α, CCR7 and Toll-like receptor-3 (TLR3) were measured after LPS and vvIBDV treatments. However, marked differences were noticed in the onset and intensity of the gene expression between these two treatment groups. LPS was far more potent than live and inactivated vvIBDV in inducing the expression of IL-1β, IL-18 and CCR7 while expression of Th1-like cytokines, IFN-γ and IL-12α were significantly increased in the live vvIBDV treatment group. Meanwhile, the expression of TLR3 was increased in live vvIBDV-infected BM-DC as compared to control. Inactivated vvIBDV-treated BM-DC failed to stimulate IFN-γ, IL-12α and TLR3 expressions. This study suggested that BM-DC may serve as another target cells during IBDV infection which require further confirmation via in vivo studies.

Matched MeSH terms: Bone Marrow
Fulltext Clinicopathological spectrum of Diffuse Large B Cell lymphoma: a study targeting population yet unexplored in Pakistan

Mahmood H, Habib M, Aslam W, Khursheed S, Fatima S, Aziz S, et al.

BMC Res Notes, 2021 Sep 10;14(1):354.
PMID: 34507605 DOI: 10.1186/s13104-021-05768-5

OBJECTIVE: Diffuse Large B Cell Lymphoma (DLBCL) is the most common type of Non-Hodgkin Lymphoma (NHL). The aim of this study was to assess the clinico pathological characteristics of DLBCL specifically, among the affected individuals residing in Northern areas of Pakistan who had not been previously included in major lymphoma studies due to their remote location.
RESULTS: Mean age of the patients was 49.7 years. Male: female ratio was 1.5:1. Primary site was lymph node in 99 (71.74%) patients, out of which, 36 (26.09%) patients had B symptoms and 19 (13.77%) patients had stage IV disease. 39 (28.26%) patients had primary extra nodal involvement, 4 (2.90%) patients had B symptoms and 3 (2.17%) had stage IV disease. Extra nodal sites involved in primary extra nodal DLBCL were gastrointestinal tract (GIT) 19 (48.72%), tonsils 6 (15.38%), spine 4 (10.26%), soft tissue swelling 3 (7.69%), parotid gland 2 (5.13%), thyroid 2 (5.13%) central nervous system (CNS) 1 (2.56), breast 1 (2.56%) and bone marrow 1 (2.56%). Our study revealed increased percentage of patients with nodal DLBCL in stage IV and with B symptoms. Few patients with primary extra nodal DLBCL had B symptoms and stage IV disease at presentation. GIT was the most common site of involvement in primary extra nodal DLBCL.

Matched MeSH terms: Bone Marrow
Fulltext Pernicious anaemia among Asians in Singapore

Jayaratnam FJ, Seah CS, Da Costa JL, Tan KK, O'Brien W

Br Med J, 1967 Jul 01;3(5556):18-20.
PMID: 6027375
Matched MeSH terms: Bone Marrow Examination
Fulltext Cutaneous mycobacterial spindle cell pseudotumour

Tan GC, Yap YP, Shiran MS, Sabariah AR, Pathmanathan R

BMJ Case Rep, 2009;2009.
PMID: 21686408 DOI: 10.1136/bcr.11.2008.1221

Mycobacterial spindle cell pseudotumour (MSCP) has been reported in various sites, including skin, lymph nodes, bone marrow, lung and spleen. Cutaneous lesions are extremely rare and the differential diagnoses include various spindle cell lesions. Literature review shows that this lesion has preponderance for upper limb involvement and occurs largely in immunosuppressed individuals. We report a case of MSCP of the skin due to atypical mycobacterium and discuss the risk of misdiagnosis as a sarcoma.

Matched MeSH terms: Bone Marrow
Fulltext Primary plasma cell leukaemia in a 39-year-old man

Kasinathan G

BMJ Case Rep, 2020 Jul 23;13(7).
PMID: 32709663 DOI: 10.1136/bcr-2020-235543

Plasma cell leukaemia (PCL) is an aggressive haematological malignancy which is classified into primary (pPCL) and secondary PCL. A 39-year-old Indian man presented to the Department of Hematology with a 2-week history of fever and lethargy. Clinically, he was pale and febrile. Haemogram revealed bicytopenia with leucocytosis. The peripheral blood film portrayed rouleax formation with 45% of circulating plasma cells. Serum protein electrophoresis and immunofixation revealed IgG lambda paraproteinaemia of 48 g/L. Bone marrow aspirate, flow cytometry and trephine were consistent with IgG lambda pPCL. He was treated with six cycles of bortezomib, thalidomide and dexamethasone combination chemotherapy followed by high-dose melphalan conditioning and autologous stem cell transplant. Currently, he is in complete remission for the past 18 months and is on oral lenalidomide maintenance therapy. Prognosis is often dismal in pPCL with the median overall survival below 1 year if treatment is delayed.

Matched MeSH terms: Bone Marrow

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