A 62-Year-Old Man With Newly Diagnosed Blastic Plasmacytoid Dendritic Cell Neoplasm (BPDCN)

An expert discusses the patient case of a man aged 62 years who is newly diagnosed with blastic plasmacytoid dendritic cell neoplasm (BPDCN). The patient initially presented to the dermatologist with a progressive and persistent rash notable for bumps and nodules. The nodules presented a violet-like color, beginning on his forehead and spreading to the rest of his body.

An expert discusses how blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematologic malignancy derived from plasmacytoid dendritic cell precursors, presenting with skin lesions, lymphadenopathy, and bone marrow involvement. For a man aged 62 years, key concerns include rapid progression, immunophenotypic complexity, and potential misdiagnosis. Diagnostic challenges arise from its rarity and overlapping features with other hematologic disorders. Improved outcomes require multidisciplinary teams, standardized testing protocols, and specialized referral centers.

An expert discusses how, historically, blastic plasmacytoid dendritic cell neoplasm (BPDCN) was treated with regimens for acute leukemia or lymphoma. Current NCCN guidelines recommend intensive multiagent chemotherapy followed by allogeneic stem cell transplantation, when possible, with targeted therapies like tagraxofusp now available for specific cases.

An expert discusses how medical professionals have integrated tagraxofusp into blastic plasmacytoid dendritic cell neoplasm (BPDCN) treatment, leveraging its CD123-targeted efficacy per 0114 trial data. Real-world findings (Angelucci et al, ASH 2023) align with clinical outcomes, reinforcing tagraxofusp’s role in BPDCN management by supporting its safety and effectiveness in broader settings.

An expert discusses how, for younger/fitter patients with blastic plasmacytoid dendritic cell neoplasm (BPDCN), treatment selection as a bridge to transplant is based on efficacy, toxicity, and response depth. Patient-specific (age, comorbidities) and systemic (drug access, center expertise) factors guide decisions. Emerging real-world evidence, such as Berning et al (ASH 2024), highlights CD123-targeted therapy’s role in optimizing response rates before allogeneic stem cell transplantation (allo-SCT).

An expert discusses how monitoring capillary leakage syndrome (CLS) requires vigilant assessment of fluid balance, hemodynamics, and biomarkers. Academic settings may have advanced resources, whereas community settings rely on standardized protocols. Key adverse effects include hypotension, edema, and organ dysfunction. Management includes fluid resuscitation, vasopressors, and close monitoring.

Panelists discuss how optimizing shared-care models between academic and community centers enhances continuity in complex hematologic malignancies. Key monitoring parameters for tagraxofusp include capillary leak syndrome risk. Timely transplant referral depends on disease kinetics. Novel therapies are among the unmet needs in plasmacytoid dendritic cell neoplasm. Support resources aid patient management. Emerging treatments and clinical insights continue to advance care.