{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T04:57:54Z","timestamp":1788238674931,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR000135"],"award-info":[{"award-number":["UL1 TR000135"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["U01CA271410"],"award-info":[{"award-number":["U01CA271410"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 CA254961"],"award-info":[{"award-number":["R01 CA254961"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Primary plasma cell leukemia (pPCL) is a rare and aggressive plasma cell disorder with inferior outcomes compared with multiple myeloma (MM). However, studies describing outcomes after first progression and subsequent lines of therapy remain limited. We retrospectively analyzed 104 patients with pPCL who progressed after first\u2010line therapy treated at one comprehensive cancer center between 2006 and 2024. Clinical characteristics, treatments, time to next treatment (TTNT), and overall survival (OS) were assessed using Kaplan\u2013Meier methods. All pPCL patients received novel agent\u2013based induction. At the time of analysis, 63% had died; median OS was 39\u2009months. High\u2010risk cytogenetics were present in 71%. The median TTNT after first\u2010line therapy was 10\u2009months. Symptomatic progression occurred in 29% of patients and was associated with significantly inferior subsequent OS (13 vs. 34\u2009months) compared with those experiencing asymptomatic biochemical progression. The TTNT progressively shortened with subsequent lines of therapy (3rd line: 6\u2009months; 4th line: 4\u2009months; 5th line: 3\u2009months). Notable exceptions included pPCL patients with\n                    <jats:italic>t<\/jats:italic>\n                    (11;14) treated with anti\u2010BCL\u20102\u2010based regimens, who achieved a median TTNT of 13\u2009months. Additionally, 24 patients received anti\u2010BCMA CAR T\u2010cell therapy. With a median follow\u2010up of 21\u2009months, their median TTNT was 32\u2009months. pPCL is characterized by frequent disease progression and diminishing response duration with successive therapeutic lines. Symptomatic progression portends particularly poor outcomes. Anti\u2010BCL\u20102\u2010based therapy in\n                    <jats:italic>t<\/jats:italic>\n                    (11;14) disease and anti\u2010BCMA CAR T\u2010cell therapy appear to provide more durable disease control and represent important advances for the management of progressed pPCL.\n                  <\/jats:p>","DOI":"10.1002\/ajh.70400","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T04:38:40Z","timestamp":1780547920000},"page":"2157-2165","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Patterns of Progression and Clinical Outcomes After First Progression in Patients With Primary Plasma Cell Leukemia"],"prefix":"10.1002","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1390-7221","authenticated-orcid":false,"given":"Daniel G.","family":"Packard","sequence":"first","affiliation":[{"name":"Division of Hematology Mayo Clinic  Rochester Minnesota 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