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Table 1 Summary of the cases and pathologic features of B-cell acute lymphoblastic lymphoma following immunomodulatory imide treatment of plasma cell myeloma

From: B-cell acute lymphoblastic leukemia in an elderly man with plasma cell myeloma and long-term exposure to thalidomide and lenalidomide: a case report and literature review

PatientRef, Yearb
(agea, sex)
PCM tx (mo on tx)B-ALL PresentationB-ALL Molecular ProfileB-ALL CytogeneticsB-ALL treatmentResponse/Duration
Index pt., 2019 (82, Male)VAD (3)
Mel/dex (5)
Thal/dex (36)
Len/dex (15)
Len (31)
Increasing M protein (0.4 g/dL)
HCT (32%)
WBC count (0.8 × 109 cells/L)
Platelet count (89 × 109 cells/L)
Marrow: 60% lymphoblasts
+: CD34, 138, TdT
Mixed: CD10, 45, HLA-DR
-: CD20, 38, Ph
Trisomy 8 + 21DVdPR (15+ mo)
Pt 1 [18], 2018
(53, Female)
RT
VD (NS)
AHSCT
Len (72)
Leukopenia
Thrombocytopenia
Marrow: 50% lymphoblasts
+: CD19, 34, 38, 79a, PAX5, TdT
Trisomy 8 + 10 + 21
Copy gain MYC, IgH
Monosomy 2
CALGB 8811
POMP maintenance
CR (12+ mo)
Pt 2 [18], 2018
(69, Female)
Bortezo/len/dex (NS)
ASHCT
Len (23)
M protein spike (0.5 g/dL)Marrow: 25% lymphoblasts
+: CD19, 22, 34
-: Ph
46, XX, t(7;19)Hyper-CVAD
POMP maintenance
CR (36+ mo)
Pt 3 [29], 2017
(59, Male)
Bortezo/len/dex (5)
AHSCT
Mel (NS)
Len (30)
Fatigue
Neutropenia
Thrombocytopenia
Marrow: 20% lymphoblasts
+: CD10, 19
Mixed: CD20, 79a, PAX5, TdT
-: Ph
Deletion 20qLinker regimen
Flu/mel/allo-SCT
CR (12+ mo)
Pt 4 [29], 2017
(34, Male)
Dex (1)
Thal/dex (36)
Len (36)
Pancytopenia
Circulating lymphoblasts
Marrow: near 100% lymphoblasts
+: CD10, 19, 22, 34, 38, 79a
Chr 14 rearrangementCALGB 8811Died during induction
Pt 5 [29], 2017
(53, Male)
RT
Bortezo/len/dex (12)
Mel/AHSCT
Len (84)
Leukopenia
Neutropenia
Marrow: 20–30% lymphoblasts
+: CD19, 34, 79a, PAX5, TdT
-: Ph
TetraploidyLinker regimen
AHSCT/BEAM
CR (12+ mo)
Pt 6 [28], 2016
(66, Male)
VD (2)
Len (2)
VADM (2)
Thal (31)
WBC count (3.05 × 109 cells/L)
No monoclonal band on SPEP
Marrow: 62% lymphoblasts
+: CD19, 22, 34, 45, TdT
Mixed: CD79a
Trisomy 4CHOPDied during induction
Pt 7 [31], 2016
(65, Female)
VADM (2)
Len (2)
VD (2)
Thal (33)
DizzinessMarrow: 68% lymphoblasts
+: CD19, 22, 34, 45, 79a, HLA-DR
-: CD20, 54, 38, 138, Ph
NSNo treatmentDied
Pt 8 [31], 2016
(63, Male)
PAD (4)
AHSCT
RT
VTD (1)
Thal (32)
Fatigue
Platelet count (33 × 109 cells/L)
No monoclonal band on SPEP
Marrow: 84% lymphoblasts
+: CD10, 34, HLA-DR
-: CD20, 38, 138
NSLost to follow-up after diagnosis
Pt 9 [31], 2016
(33, Female)
DVd (1)
VD (4)
AHSCT
Thal (73)
Cough
Fatigue
Hgb (10.9 g/dL)
No monoclonal band on SPEP
Marrow: 84% lymphoblasts
+: CD10, 19, 22, 34, 79a, HLA-DR
-: CD20, 25
NSNo treatmentLost to follow-up
Pt 10 [27], 2013
(62, Female)
VD (4)
High-dose dex (2)
VBMCP/VBAD (5)
Len/dex (3)
AHSCT
Len (20)
Fatigue
Pancytopenia
+: Ph, CD10, 19, 20, 22, 79a, TdT
-: CD34
46, XXNSDied during induction
Pt 11 [33], 2013
(72, Male)
VAD (4)
RT
Len/dex (36)
Pancytopenia
No evidence of active MM
Marrow: 66% lymphoblasts
+: CD10, 19, 20, 79a, TdT
-: CD34, 38
NSHyper-CVAD
POMP maintenance
CR (12 mo) then relapse
Pts 12–14 [36], 2012
(NS, NS)
AHSCT
Len (NS)
NSNSNSNSNS
Pt 15 [26], 2012
(NS, NS)
AHSCT
Len (NS)
NSNSNSNSNS
Pt 16 [30], 2012 (61, Female)VCMP (7)
VMAP (4)
Thal (29)
Pancytopenia
No monoclonal band on SPEP
Marrow: 93% lymphoblasts
+: CD19, 38
-: CD10, 20, 23, 138
46, XXCALGB 9911
Relapse: VP
CR (10 mo) then relapse
Relapse: CR (12+ mo)
Pt 17 [32], 2012 (56, Female)VCMP (7)
Mel/thal/dex (16) Thal (53)
Edema
Dyspnea
WBC count (3.077 × 109 cells/L) Hgb (8.6 g/dL)
Platelet count (80 × 109 cells/L)
Marrow: 37.8% lymphoblasts
+: CD10, 19, 20, 22, HLA-DR
-: Ph
46, XXSteroidsDied
  1. Abbreviations: AHSCT autologous hematopoietic stem cell transplant, ALL acute lymphoblastic leukemia, allo-SCT allogenic stem cell transplant, BEAM carmustine, etoposide, cytarabine, and melphalan, bortezo bortezomib, CALGB 8811 Cancer and Leukemia Group B Protocol 8811: daunorubicin, vincristine, prednisone, pegasparagase, and cyclophosphamide, CALGB 9111 Cancer and Leukemia Group B Protocol 9111: cyclophosphamide, daunorubicin, vincristine, prednisone, and L-asparaginase with granulocyte-colony stimulating factor, CHOP cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisone, Chr chromosome, CR complete response, dex dexamethasone, DVd liposomal doxorubicin, vincristine, and dexamethasone, flu fludarabine, HCT hematocrit, Hgb hemoglobin, hyper-CVAD hyperfractionated cyclophosphamide, vincristine, doxorubicin hydrochloride, dexamethasone, and alternating high-dose methotrexate and cytarabine, InO inotuzumab ozogamicin, len lenalidomide, Linker regimen daunorubicin, vincristine, prednisone, and pegaspargase, M monoclonal, mel melphalan, mo months, NS not stated, PAD bortezomib, dexamethasone, and doxorubicin, PCM plasma cell myeloma, PD progressive disease, Ph Philadelphia chromosome (BCR-ABL1 fusion), POMP 6-mercaptopurine, vincristine, methotrexate, prednisone, PR partial response, pt patient, Ref reference, RT radiation therapy, SPEP serum protein electrophoresis, TdT terminal deoxynucleotidyl transferase, thal thalidomide, tx treatment, VAD vincristine, doxorubicin, and dexamethasone, VADM vincristine, pirarubicin/doxorubicin, dexamethasone, and melphalan, VBAD carmustine, doxorubicin, and dexamethasone, VBMCP vincristine, carmustine, melphalan, cyclophosphamide, and prednisone, VCMP vincristine, cyclophosphamide, melphalan, and prednisone, VD bortezomib and dexamethasone, VMAP vincristine, melphalan, doxorubicin, and prednisone, VP vincristine and prednisone, VTD bortezomib, dexamethasone, and thalidomide, WBC white blood cell
  2. a age at diagnosis
  3. b year reported