Background/Aims: The study was undertaken to understand the characteristic of plasma cell leukemia (PCL) in China. Methods: We reviewed and compared medical data of 22 primary PCL, 9 secondary PCL and 461 multiple myeloma (MM) diagnosed at our institute from January 2000 to January 2008. Results: The median onset ages of primary and secondary PCL patients were 49.5 and 56 years, respectively. PCL patients presented with a low peripheral blood plasmacytosis, extensive involvement of visceral organs and poor residual bone marrow function, without severe renal insufficiency. Seventeen of twenty-one PCL patients had abnormal karyotypes, mostly complex and hypodiploid or pseudodiploid. The deletion of 13q was frequent in primary and secondary PCL (57.1 and 42.9%, respectively). There was a significant difference in survival among primary PCL, secondary PCL and MM (median 14, 2 and 37 months, respectively, p = 0.0000). Conclusion: Overall, primary and secondary PCL are different disorders with distinct natural histories and survival.