Primary Plasma Cell Leukaemia in a Young HIV Infected Male, Associated with Epstein-barr Virus

Main Article Content

Rakhi V. Jagdale
Jaydeep N. Pol
Zeba Nisar
Sachin J. Patil
Abhijit S. Pethkar
D. N. Lanjewar

Abstract

Background: Primary Plasma Cell Leukaemia (PPCL) in young patients has been evaluated in very few studies in the English literature. The aim of this study is to describe a case of PPCL in a young HIV infected male associated with EBV. This is first such case in Indian literature. This is an interesting study that reported a rare case where primary plasma cell leukaemia is observed in a young HIV infected male, which will be valuable case for future studies. Thorough clinical examinations were done and reported in detail.

Methods: A 35 years old male presented with abdominal pain, backache and asthenia. A thorough workup was done including clinical examination, CBP, KFT, LFT, serology (HIV, HBsAg), Serum electrophoresis, radiology and bone marrow examination. A systematic literature review was conducted by searching the Pub Med and National Centre for Biotechnology Information database.

Results: Patient had hepatosplenomegaly and icterus. Peripheral smear revealed atypical plasma cells (53%). Serum protein electrophoresis showed a monoclonal IgG-K paraprotein at a concentration of 4.56 (45 g/l) (Ref- 0.10-0.40). Patient had hypoalbuminemia and raised liver enzymes. The serology test for HIV was reactive for HIV-I and II. Bone marrow examination showed hypercellularity with near replacement of the normal marrow elements by sheets of mature plasma cells and a few immature plasma cells. Plasma cells were EBER positive. Based on the overall findings, a diagnosis of PPCL was made and subsequently, the patient was referred for chemotherapy.

Conclusion: To our knowledge PPCL in HIV infected young male associated with EBV has not been previously reported in the Indian literature. Given the rare incidence of this entity in the general population, it is very unlikely that they occurred by chance. Further research is needed to determine what would be the optimal management options of such patients.

Keywords:
Primary plasma cell leukaemia, HIV, EBER.

Article Details

How to Cite
Jagdale, R. V., Pol, J. N., Nisar, Z., Patil, S. J., Pethkar, A. S., & Lanjewar, D. N. (2020). Primary Plasma Cell Leukaemia in a Young HIV Infected Male, Associated with Epstein-barr Virus. Asian Hematology Research Journal, 3(1), 10-16. Retrieved from https://journalahrj.com/index.php/AHRJ/article/view/30122
Section
Case Report

References

San-Miguel JF, Garcia-Sanz R, Gonzale M, Orfao A. Immunophenotype and DNA cell count in multiple myeloma. Baillieres Clin Haematol. 1995;8:735-59.

Dimopoulos MA, Palumbo A, Delasalle KB, Alexanian R. Primary plasma cell leukaemia. Br J Haematol. 1994;88:754-9.

Grogan TM, Muller-Mermelink HK, Van CB, Harris NL, Kyle RA. WHO classification of Haematopoeitic and lymphoid tissues-edition. IARC: Lyon, International Agency for Research on Cancer. 2001;142-56.

Kyle RA, Maldonado JE, Bayrd ED. Plasma cell leukemia. Report on 17 cases. Arch Intern Med. 1974;133:813-8.

International Myeloma working group. Criteria for classification of monoclonal gammopathies, multiple myeloma and related disorders: A report of the International myeloma working group. Br. J. Haematol. 2003;121:749-57.

Costello R, Sainty D, Bouabdallah R, Fermand JP. Delmer A, Diviné Metal. Primary plasma cell leukaemia: A report of 18 cases. Leuk Res. 2001;25:103-7.

Raj RS, Najeeb S, Aruna R, et al. Primary plasma cell leukaemia occurring in the young. Indian J Cancer. 2003;40:116–7.

Jain D, Singh T, Akhila L, Ghosh N. Primary plasma cell leukemia in a 30-year-old woman. Indian J Pathol Microbio. 2008; 51(3):456–7.

Dezube BJ, Aboulafia DM, Pantanowitz L. Plasma cell disorders in HIV-infected patients: From benign gammopathy to multiple myeloma. AIDS Read. 2004;14: 372–374,377–9.

Biggar RJ, Chaturvedi AK, Bhatia K, Mbulaiteye SM. Cancer risk in persons with HIV/AIDS in India: A review and future directions for research. Infect Agent Cancer. 2009;4:4.

Chitale AR. Cancer and AIDS. Indian J Pathol Microbiol. 2005;48:151–60.

Henberger L, Costello RT. First case of Plasma cell leukaemia co-existing with HIV infection. Leukaemia. 1998;12:103-4.

Konrad RJ, Kricka LJ, Goodman DB, et al. Brief report: Myeloma-associated paraprotein directed against the HIV-1 p24 antigen in an HIV-1-seropositive patient. N Engl J Med. 1993;328:1817–9.

Voelkerding KV, Sandhaus LM, Kim HC, Wilson J, Chittenden T, Levine AJ, Raska K. Jr Plasma cell malignancy in the acquired immune deficiency syndrome. Association with Epstein-Barr virus. Am J Clin Pathol. 1989;92(2):222–8.

Fiorino AS, Atac B. Paraproteinemia, plasmacytoma, myeloma and HIV infection. Leukemia. 1997;11:2150–6.

Blade J, Kyle RA, Greipp PR. Multiple myeloma in patients younger than 30 years: Report of 10 cases and review of the literature. Arch Intern Med. 1996;156: 1463–8.

Christoph P. Jung, Sophia Horster, Peter Lohse, Johannes R. Bogner, Bertold Emmerich, Frank D. Goebel. Plasmablastic leukemia in HIV-associated multicentric castleman’s disease. Journal of Clinical Oncology. 2003;21:4248-9.