P-014 Demographics and Survival in Plasma Cell Leukemia (SEER data analysis)

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Conference Proceeding

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American Journal of Hematology


Purpose of the Study: Plasma cell leukemia (PCL) is a rare hematologic malignancy. The demographics of PCL patients and the impact of che- motherapy on survival are poorly characterized. Summarized Description of the Project: This was a retrospective analysis conducted on all cases of PCL diagnosed between 2005 and 2010 extracted from the Surveillance Epidemiology and End Results program (SEER) using ICD-O-3 code 9733. Frequency, demographics, and survival data were assessed using JMP statistical software. The SEER database does not record specific age above 85 years; for this reason, 15 cases were excluded. An additional 2 cases were excluded for missing survival time. Results: A total of 161 cases of PCL were identified. Most were Cauca- sian (112, 70%) and female (89, 55%); the average age was 64 ± 11 years. One hundred ten (68%) received chemotherapy. Overall median survival at 5 years was 9 months (95% CI 6 to 13 months). Patients who received chemotherapy had improved early mortality (11 months, 95% CI 7 to 16 months) compared to those who did not (4 months, 95% CI 0 to 13 months, Wilcoxon p=0.01) in the unadjusted Kaplan-Meier analysis. PCL-specific survival was significantly higher (19 months) compared to overall survival. At time of analysis, 91.9% of patients were deceased and 61% of those deaths were attributable to PCL. In a proportional hazards model male sex, Caucasian race and age at diagnosis were associated with increased mortality (HR 1.09, 95% CI 0.76-1.58; HR 1.34, 95% CI 0.96-1.86; HR 1.026 per unit, 95% CI 0.44-2.4 respectively); use of chemotherapy was associated with improved survival (HR 0.88, 95% CI 0.6-1.31). None of the former asso- ciations proved statistically significant. Conclusion: Historically, plasma cell leukemia is considered more common in males and African Americans. Interestingly, in the 2005-2010 SEER subset analyzed Caucasians and females accounted for the majority cases. More aggressive disease in the black population may account for length- time bias. Underdiagnosis, undertreatment and a true change in the natu- ral history of PCL are also possible. The impact of chemotherapy on sur- vival appears minimal when accounting for age, sex and ethnicity.





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2019 Lymphoma and Myeloma Congress October 23-26, 2019 New York NY. Meeting Abstract:P-014

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