Fernandez de Larrea et al reported criteria for the diagnosis and management of plasma cell leukemia (PCL). One lists the criteria for relapse after a complete remission. The authors are from the International Myeloma Working Group (IMWG).


Patient selection: plasma cell leukemia that has achieved complete remission


Criteria for relapse – one or more of the following:

(1) appearance of any extramedullary disease

(2) reappearance of plasma cells in peripheral blood

(3) > 10% increase in plasma cells within the bone marrow

(4) reappearance of original monoclonal protein in serum by immunofixation

(5) reappearance of original monoclonal protein in urine by immunofixation



• In complete relapse the number of bone marrow plasma cells is less than 5% plus no malignant plasma cells. At low plasma cell counts a 10% increase may be a small absolute increase.

• In a bone marrow aspirate 500 cells are typically counted.

• In a peripheral smear 200 cells are typically counted.


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