Therapeutic difficulties in the patient with coexistance of chronic myeloid leukemia and plasma cell myeloma

Abstract

Neoplastic disorders derived from lymphoid or hematopoietic lineages have been hitherto rarely described in cases where they jointly occur. Here a patient with chronic myeloid leukemia (CML) and plasma cell myeloma (PCM) is presented with proliferation of leukemia cells being dominant at presentation. Following several months of treatment with tyrosine kinase inhibitors, suppression of the leukemic clone was achieved but with a concomitant proliferation of bone marrow plasma cells. Subsequent chemotherapy resulted in partial remission of PCM however proliferation of leukemia cells was again noted. Due to this treatment regime being ineffective it was therefore decided to replace any further treatment with interferon alpha which is recognized to be active against PCM and CML cells. Minimal doses of nilotynib may also be given if adequate hematological tolerance were to be observed.