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Hurley MY, Ghahramani GK, Frisch S, Armbrecht ES, Lind AC, Nguyen TT, Hassan A, Kreisel FH, Frater JL. Cutaneous myeloid sarcoma: natural history and biology of an uncommon manifestation of acute myeloid leukemia. Acta Derm Venereol 2013; 93:319-24. [PMID: 23165700 DOI: 10.2340/00015555-1458] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We conducted a retrospective study of patients with cutaneous myeloid sarcoma, from 2 tertiary care institutions. Eighty-three patients presented, with a mean age of 52 years. Diagnosis of myeloid sarcoma in the skin was difficult due to the low frequency of myeloperoxidase and/or CD34+ cases (56% and 19% of tested cases, respectively). Seventy-one of the 83 patients (86%) had ≥ 1 bone marrow biopsy. Twenty-eight (39%) had acute myeloid leukemia with monocytic differentiation. Twenty-three had other de novo acute myeloid leukemia subtypes. Thirteen patients had other myeloid neoplasms, of which 4 ultimately progressed to an acute myeloid leukemia. Seven had no bone marrow malignancy. Ninety-eight percent of the patients received chemotherapy, and approximately 89% died of causes related to their disease. Cutaneous myeloid sarcoma in most cases represents an aggressive manifestation of acute myeloid leukemia. Diagnosis can be challenging due to lack of myeloblast-associated antigen expression in many cases, and difficulty in distinguishing monocyte-lineage blasts from neoplastic and non-neoplastic mature monocytes.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Analysis of Variance
- Antineoplastic Agents/therapeutic use
- Biopsy
- Bone Marrow Examination
- Chi-Square Distribution
- Child
- Child, Preschool
- Female
- Flow Cytometry
- Humans
- Immunohistochemistry
- Infant
- Infant, Newborn
- Karyotyping
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/mortality
- Leukemia, Myeloid, Acute/pathology
- Male
- Middle Aged
- Missouri
- Predictive Value of Tests
- Retrospective Studies
- Sarcoma, Myeloid/diagnosis
- Sarcoma, Myeloid/drug therapy
- Sarcoma, Myeloid/genetics
- Sarcoma, Myeloid/mortality
- Sarcoma, Myeloid/pathology
- Skin/pathology
- Skin Neoplasms/diagnosis
- Skin Neoplasms/drug therapy
- Skin Neoplasms/genetics
- Skin Neoplasms/mortality
- Skin Neoplasms/pathology
- Tertiary Care Centers
- Time Factors
- Treatment Outcome
- Young Adult
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27
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Niiyama S, Amoh Y, Watarai A, Katsuoka K, Mukai H. Cutaneous myeloid sarcoma presenting as grey pigmented macules. Acta Derm Venereol 2012; 92:629-30. [PMID: 22278733 DOI: 10.2340/00015555-1312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
MESH Headings
- Aclarubicin/administration & dosage
- Aged
- Antineoplastic Combined Chemotherapy Protocols
- Biomarkers, Tumor/analysis
- Chromosomes, Human, Pair 21
- Chromosomes, Human, Pair 7
- Cytarabine/administration & dosage
- Cytarabine/analogs & derivatives
- Humans
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/immunology
- Leukemia, Myeloid, Acute/pathology
- Male
- Sarcoma, Myeloid/drug therapy
- Sarcoma, Myeloid/genetics
- Sarcoma, Myeloid/immunology
- Sarcoma, Myeloid/pathology
- Skin/drug effects
- Skin/immunology
- Skin/pathology
- Skin Neoplasms/drug therapy
- Skin Neoplasms/genetics
- Skin Neoplasms/immunology
- Skin Neoplasms/pathology
- Skin Pigmentation
- Translocation, Genetic
- Treatment Outcome
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28
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Serrao A, Loglisci G, Salaroli A, Zacheo I, Alimena G, Breccia M. Azacitidine followed by radiotherapy as effective treatment for chronic myelomonocytic leukemia with extramedullary localization. Leuk Lymphoma 2012; 54:411-2. [PMID: 22694794 DOI: 10.3109/10428194.2012.702905] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
MESH Headings
- Antimetabolites, Antineoplastic/administration & dosage
- Antimetabolites, Antineoplastic/therapeutic use
- Azacitidine/administration & dosage
- Azacitidine/therapeutic use
- Combined Modality Therapy
- Humans
- Leukemia, Myelomonocytic, Chronic/drug therapy
- Leukemia, Myelomonocytic, Chronic/radiotherapy
- Leukemia, Myelomonocytic, Chronic/therapy
- Male
- Middle Aged
- Sarcoma, Myeloid/drug therapy
- Sarcoma, Myeloid/radiotherapy
- Treatment Outcome
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29
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Tang TC, Chang H, Chuang WY. Complete response of myeloid sarcoma with FIP1L1-PDGFRA -associated myeloproliferative neoplasms to imatinib mesylate monotherapy. Acta Haematol 2012; 128:83-7. [PMID: 22722648 DOI: 10.1159/000338217] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Accepted: 03/06/2012] [Indexed: 01/31/2023]
Abstract
Myeloid sarcoma (MS) is a localized, extramedullary tumor of acute myeloid leukemia (AML) that typically presents either de novo or concomitantly with myeloproliferative neoplasms (MPN), AML and myelodysplastic syndrome. Patients who have MS must be treated with intensive chemotherapy, as are patients with AML, because MS usually progresses to a systemic manifestation and leads to dismal outcomes. FIP1L1-PDGFRA-associated MPN, a subtype of myeloid and lymphoid neoplasm, is characterized by eosinophilia and abnormalities in the PDGFRA, PDGFRB or FGFR1 gene. Fusion of the FIP1L1 and PDGFRA genes activates the tyrosine kinase. As a result, imatinib mesylate (IM) is widely used for the treatment of this disorder. The coexistence of FIP1L1-PDGFRA-associated MPN and MS is extremely rare. Patients with this condition fail to achieve durable remission and long-term survival without a combination of intensive chemotherapy and IM. Here, we report a case of MS and FIP1L1-PDGFRA-associated MPN that was successfully treated with IM monotherapy.
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30
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Cunningham I. A basis for updating our approach to resistant acute leukemia. Am J Hematol 2012; 87:251-7. [PMID: 22287495 DOI: 10.1002/ajh.22256] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Revised: 10/17/2011] [Accepted: 11/10/2011] [Indexed: 12/12/2022]
Abstract
No studies exist documenting that chemotherapy alone eradicates tumors composed of leukemic cells in a large group of patients with tumors at any one site. Yet, its use has continued over 40 years in the absence of data. Consensus protocols exist only for testis and meningeal tumors, relying on local therapy. To constitute a body of knowledge about tumors at one site, the breast was chosen and all published cases were analyzed, with follow-up obtained, to document the behavior of acute leukemia tumors and survival after presentation. Among 235 cases (52% published since 2000), overall survival was poor, particularly for the 43% with concurrent morphologic marrow relapse, with 66-73% one-year mortality. Only 4 of 106 patients treated with chemotherapy alone survived 4 years. The majority of AML and ALL tumors were only transiently responsive to anti-leukemia treatments, including transplant, and next relapses were as, or more, common in further tumors than in marrow. A pattern of tumors similar to the metastases of invasive lobular breast cancer was revealed. When relapse occurred in marrow, durable remission was only rarely obtained. These data suggest a potential benefit of incorporating extent of disease workup at diagnosis and relapse into prospective trials. This could yield an accurate incidence of extramedullary tumors and a means to identify occult residual disease which could lead to marrow relapse. This approach could potentially result in greater success in curing acute leukemias.
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31
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Breccia M, Alimena G. Isolated myeloid sarcoma without bone marrow involvement. CLINICAL ADVANCES IN HEMATOLOGY & ONCOLOGY : H&O 2012; 10:66-67. [PMID: 22398813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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32
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Lee EYP, Leung AYH, Anthony MP, Loong F, Khong PL. Utility of 18F-FDG PET/CT in identifying terminal ileal myeloid sarcoma in an asymptomatic patient. Am J Hematol 2011; 86:1036-7. [PMID: 21800353 DOI: 10.1002/ajh.22077] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Revised: 04/28/2011] [Accepted: 05/02/2011] [Indexed: 11/11/2022]
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33
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Dym H, Movahed R. Granulocytic sarcoma of palate. Case report and review of literature. THE NEW YORK STATE DENTAL JOURNAL 2011; 77:24-27. [PMID: 21735867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A rare case of granulocytic sarcoma of the hand and palate, also known as chloroma, occurring in an adolescent patient is presented. Diagnostic clinical criteria, along with treatment pictures, are also reviewed.
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34
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Liu HY, Yin HL, DU J, Cai Y, Lu ZF, Zhou HB, Zhou XJ. [Clinicopathologic features of granulocytic sarcoma: a study of 38 cases]. ZHONGHUA BING LI XUE ZA ZHI = CHINESE JOURNAL OF PATHOLOGY 2010; 39:172-176. [PMID: 20450763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To study the clinicopathologic features of granulocytic sarcoma. METHODS The clinical and pathologic findings of 38 cases of granulocytic sarcoma were retrospectively analyzed. Immunohistochemical study was performed and the literature was reviewed. RESULTS The age of patients ranged from 2 to 77 years (mean = 43.3 years). The male-to-female ratio was 1.5:1. Major clinical presentations included superficial lymph node enlargement and painful soft tissue mass. Follow-up data were available in 18 patients; and 14 of them died of tumor-related diseases. The average duration of survival of the patients was 16.9 months. Histologically, the tumor cells were relatively uniform in appearance and small to medium in size. The cytoplasm was scanty and pale in color. The nuclei were round or focally irregular, with fine chromatin and inconspicuous nucleoli. Mitosis figures were readily identified. Scattered immature eosinophilic myelocytes were seen. Immunohistochemical study showed that the tumor cells in all cases expressed MPO and CD43. Most cases were also positive for CD68, lysozyme, CD99 and TdT. The staining for CD3, CD20, CD79a, pan-cytokeratin and PLAP were negative. CONCLUSIONS Granulocytic sarcoma is a known histologic mimicker of non-Hodgkin lymphoma, Ewing sarcoma/PNET and embryonal rhabdomyosarcoma. Detailed morphologic examination, when coupled with immunohistochemical study, is useful in arriving at a correct diagnosis.
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35
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Yasuda H, Ando J, Sato E, Inagaki N, Aritaka N, Komatsu N, Hirano T. Successful treatment of extramedullary tumors with low-dose thalidomide in patients with multiple myeloma. Intern Med 2010; 49:2617-20. [PMID: 21139303 DOI: 10.2169/internalmedicine.49.4215] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Extramedullary tumor (EMT) is a poor prognostic factor of multiple myeloma (MM). The majority of patients report poor efficacy of thalidomide in MM with EMT, and bortezomib is the preferred choice of treatment. We report two cases of MM with EMTs in which thalidomide was highly beneficial. Case 1 has been in remission for ten months with 100 mg every other day of thalidomide monotherapy, which is the lowest dose to be reported in a successfully treated case of MM with EMT. Case 2 eventually became refractory, but low dose thalidomide gave excellent disease control over a period of eleven weeks, despite the EMT being in a highly aggravated state. Some reports have speculated that EMT cases with preceding bone marrow transplantation (BMT) are an exception and have a good response to thalidomide, but the present two cases have no history of BMT. In conclusion, low dose thalidomide can be effective in MM with EMT and should be considered as a treatment option, especially in the elderly.
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36
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Gorman M, Ahmed KA, Pallera A, Samant S. Granulocytic sarcoma of the nasal cavity: a case report. EAR, NOSE & THROAT JOURNAL 2009; 88:1210-1212. [PMID: 19924663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Granulocytic sarcoma of the nasal cavity is exceedingly rare. We describe the case of a 55-year-old man who presented with an intranasal mass that was later diagnosed as a granulocytic sarcoma. The mass was treated with rapid initiation of chemotherapy, which produced a substantial decrease in tumor bulk. Granulocytic sarcoma is often mistaken for lymphoma or other poorly differentiated malignancies, and the correct diagnosis requires a high index of clinical suspicion.
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37
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Kara IO, Sahin B, Paydas S, Kara B. Granulocytic sarcoma of the heart: Extramedullary relapse of acute myeloblastic leukemia after allogeneic stem cell transplantation successfully treated by chemotherapy alone. Leuk Lymphoma 2009; 46:1081-4. [PMID: 16019562 DOI: 10.1080/10428190500057700] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
We present a case of granulocytic sarcoma (GS) of the heart. A 28-year-old man with relapsed acute myelogenous leukemia (AML-M2) had undergone a non-myeloablative allogeneic peripheral stem cell transplantation. Three years following transplantation, masses were evidenced in his heart by echocardiography but had completely disappeared following a common chemotherapy etoposide, mitoxantrone, ara-C (EMA) regimen for relapsed AML. The involvement of the heart with GS is very rare and this is the first case of extramedullary disease in the heart after allogeneic transplantation. Here we present the case history and related literature has been reviewed.
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38
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Piccaluga PP, Martinelli G, Rondoni M, Malagola M, Gaitani S, Isidori A, Bonini A, Gugliotta L, Luppi M, Morselli M, Sparaventi G, Visani G, Baccarani M. Gemtuzumab Ozogamicin for Relapsed and Refractory Acute Myeloid Leukemia and Myeloid Sarcomas. Leuk Lymphoma 2009; 45:1791-5. [PMID: 15223637 DOI: 10.1080/1042819042000219485] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Antibody-targeted chemotherapy is a promising approach in patients with hematological malignancies. In particular, gemtuzumab ozogamicin (GO, formerly CMA-676), an anti-CD33 antibody linked to calicheamicin, has been approved for the treatment of elderly patients with acute myeloid leukemia (AML) in relapse. Nevertheless, no data are until now available concerning the possible efficacy of GO for myeloid sarcomas (MS). We treated with GO 24 AML patients, in 5 cases presenting with myeloid sarcomas of the skin or bones. The overall complete response rate was 21%. The median duration of response was 6 months. Four out of the 5 patients with myeloid sarcoma showed a regression of the masses, in two cases also obtaining a clearance of marrow blasts. The most common adverse events included thrombocytopenia, neutropenia, infections, elevation of bilirubin and hepatic transaminases. Notably, severe bleeding occurred in 5 cases (21%). VOD was documented in 1 case. We conclude that GO is effective as a single agent in AML and myeloid sarcomas. Further data are required to clarify the possible correlation between GO administration and occurrence of bleeding.
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MESH Headings
- Adult
- Aged
- Aminoglycosides/administration & dosage
- Aminoglycosides/adverse effects
- Aminoglycosides/immunology
- Aminoglycosides/therapeutic use
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal/adverse effects
- Antibodies, Monoclonal/immunology
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Cause of Death
- Female
- Gemtuzumab
- Humans
- Immunotherapy
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/immunology
- Male
- Middle Aged
- Recurrence
- Sarcoma, Myeloid/drug therapy
- Sarcoma, Myeloid/immunology
- Treatment Outcome
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39
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Thiriat S, Kremer S, Zollner G, Dietemann JL. [Answer to june e-quid. Imaging features of meningioma in a patient with underlying myeloproliferative disorder: consider chloroma]. JOURNAL DE RADIOLOGIE 2009; 90:849-851. [PMID: 19752794 DOI: 10.1016/s0221-0363(09)73220-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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40
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Rodríguez Pérez A, López Carrizosa MC, Villalón Blanco L, Samper Ots PM, Ortiz Cruz E. Granulocytic sarcoma of the right humerus in a non-leukaemia patient. Clin Transl Oncol 2008; 10:758-60. [PMID: 19015073 DOI: 10.1007/s12094-008-0283-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Granulocytic sarcoma (GS), an uncommon solid extramedullary tumour, should be considered even in the absence of leukaemia, as delay in diagnosis and treatment worsens the prognosis. We present a GS (single humeral bone lesion) in a non-leukaemia patient, treated with intensive AML (Acute Myeloid Leukaemia) chemotherapy and sequential radiotherapy, in complete response 26 months after diagnosis, confirmed by histopathology and without leukaemia progression.
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41
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Slavcheva V, Lukanov T, Tzvetkov N. Two cases of extramedullary myeloid tumor in patients with continuous remission of acute myeloblastic leukemia. JOURNAL OF B.U.ON. : OFFICIAL JOURNAL OF THE BALKAN UNION OF ONCOLOGY 2008; 13:589-592. [PMID: 19145688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Myeloid sarcoma is described as tumor mass consisting of myeloblasts or immature myeloid cells, involving extramedullary tissues. It can be initial manifestation of myeloproliferative disorders or relapse of previously treated acute myeloblastic leukemia (AML). We present two patients, one with AML-M2 and the other with acute promyelocytic leukemia (APL)-M3. After remission induced by conventional chemotherapy, which continued for 3 and 10 years respectively, a myeloid sarcoma was diagnosed. Biopsy of a retroauricular tumor formation was made in the first case. The second one was diagnozed after biopsy of a supraclavicular lymph node. In both cases complete laboratory investigation including blood smear, differential counting and flow cytometric analysis of bone marrow were normal. Despite this, the patients received chemotherapy. The APL-M3 patient was treated with radiotherapy to the involved supraclavicular lymph node which was followed by chemotherapy. Three months after radiotherapy bone marrow infiltration and blast cells in the peripheral blood were found. Two years after the diagnosis of myeloid sarcoma the patient died of haemorrhagic stroke. The patient with AML-M2 continued treatment with polychemotherapy.
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42
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Shah C, Gopaluni S, Husain J, Rajan A, Shah H. Granulocytic sarcoma in a patient with myelodysplastic syndrome. ONCOLOGY (WILLISTON PARK, N.Y.) 2008; 22:950-953. [PMID: 18709903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Granulocytic sarcomas (GS) are uncommon extramedullary tumors composed of immature cells of the granulocytic or myeloid series. Treatment for GS should be directed toward the underlying hematologic disorder. There is no standard treatment.
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43
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Quintás-Cardama A, Harb AJ, Amin HM, Verstovsek S. Granulocytic sarcoma with massive scalp involvement. Am J Hematol 2008; 83:340-2. [PMID: 17685484 DOI: 10.1002/ajh.20909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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44
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Worch J, Ritter J, Frühwald MC. Presentation of acute promyelocytic leukemia as granulocytic sarcoma. Pediatr Blood Cancer 2008; 50:657-60. [PMID: 17437290 DOI: 10.1002/pbc.21190] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Granulocytic sarcoma (GS) is a localized tumor composed of immature myeloid cells. This extramedullary tumor can present before, concurrent with or after the diagnosis of acute myeloid leukemia. GS is extremely uncommon in acute promyelocytic leukemia (APL). As a proportion of patients never develop systemic disease, correct and timely diagnosis may be rather difficult, but is a prerequisite for optimal outcome. GS should be considered in the differential diagnosis of children with unusual bone lesions. We describe a patient with GS who presented with symptoms mimicking osteomyelytis or rheumatoid disease.
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MESH Headings
- Adolescent
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Arthritis, Psoriatic/diagnosis
- Biomarkers, Tumor/analysis
- Diagnostic Errors
- Female
- Humans
- Leukemia, Promyelocytic, Acute/complications
- Leukemia, Promyelocytic, Acute/diagnosis
- Leukemia, Promyelocytic, Acute/drug therapy
- Oncogene Proteins, Fusion/analysis
- Osteolysis/etiology
- Osteomyelitis/diagnosis
- Remission Induction
- Sarcoma, Myeloid/drug therapy
- Sarcoma, Myeloid/etiology
- Shoulder Pain/etiology
- Tretinoin/administration & dosage
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45
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MESH Headings
- Adrenal Gland Neoplasms/complications
- Adrenal Gland Neoplasms/diagnostic imaging
- Adrenal Gland Neoplasms/drug therapy
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Cytarabine/therapeutic use
- Daunorubicin/therapeutic use
- Fatal Outcome
- Female
- Gingiva/pathology
- Humans
- Hypertrophy
- Leukemia, Myelomonocytic, Acute/complications
- Leukemia, Myelomonocytic, Acute/diagnostic imaging
- Leukemia, Myelomonocytic, Acute/drug therapy
- Middle Aged
- Sarcoma, Myeloid/complications
- Sarcoma, Myeloid/diagnostic imaging
- Sarcoma, Myeloid/drug therapy
- Tomography, X-Ray Computed
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46
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Ponziani V, Mannelli F, Bartalucci N, Gianfaldoni G, Leoni F, Antonioli E, Guglielmelli P, Ciolli S, Bosi A, Vannucchi AM. No role for CXCL12–G801A polymorphism in the development of extramedullary disease in acute myeloid leukemia. Leukemia 2007; 22:669-71. [PMID: 17805324 DOI: 10.1038/sj.leu.2404938] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
MESH Headings
- Acute Disease
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Alleles
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Chemokine CXCL12/genetics
- Chemokine CXCL12/physiology
- Disease-Free Survival
- Female
- Genotype
- Humans
- Leukemia, Myeloid/drug therapy
- Leukemia, Myeloid/genetics
- Leukemia, Myeloid/mortality
- Leukemia, Myeloid/pathology
- Male
- Middle Aged
- Neoplasm Proteins/genetics
- Neoplasm Proteins/physiology
- Polymorphism, Single Nucleotide
- Proportional Hazards Models
- Receptors, CXCR4/physiology
- Remission Induction
- Sarcoma, Myeloid/drug therapy
- Sarcoma, Myeloid/genetics
- Sarcoma, Myeloid/pathology
- Survival Analysis
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47
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Owonikoko T, Agha M, Balassanian R, Smith R, Raptis A. Gemtuzumab therapy for isolated extramedullary AML relapse following allogeneic stem-cell transplant. ACTA ACUST UNITED AC 2007; 4:491-5. [PMID: 17657254 DOI: 10.1038/ncponc0899] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2007] [Accepted: 06/04/2007] [Indexed: 01/21/2023]
Abstract
BACKGROUND A 19-year-old male with primary refractory acute myeloid leukemia received salvage therapy with mitoxantrone and cytarabine combination. He received consolidation therapy 3 months later with a matched-unrelated-donor stem-cell transplant. The disease relapsed in the bone marrow (BM) 9 months after the initial stem-cell transplant, and was successfully treated by repeat transplant from the same donor. Ten months following repeat transplant, the patient presented with an increasing number of extramedullary sites of biopsy-proven disease relapse (i.e. cranial and peripheral nerves, tongue, abdominal wall and chest wall). Repeated biopsy of the BM and chimera study showed no morphologic evidence of leukemic infiltrate with 100% donor-cell population. INVESTIGATIONS Physical examination, complete blood count, BM biopsy, flow cytometry, cytogenetic analysis, chimera study, tongue biopsy, abdominal-wall biopsy, cytology and immunohistochemistry, CT scan of the chest, abdomen and pelvis, MRI of the brain, and cerebrospinal fluid analysis. DIAGNOSIS Isolated extramedullary relapse of acute myeloid leukemia after stem-cell transplant. MANAGEMENT Primary leukemia treatment with idarubicin, cytarabine, etoposide, dexamethasone, tioguanine on protocol and salvage therapy with mitoxantrone and cytarabine combination for primary refractory disease. A matched-unrelated-donor stem-cell transplant for consolidation and donor-lymphocyte infusions were performed, followed by repeat unrelated-donor transplant for leukemia relapse in the marrow, radiation therapy and gemtuzumab ozogamicin for multiple sites of extramedullary leukemia relapse.
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48
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Scholl S, Lüftner J, Mügge LO, Schmidt V, Fricke HJ, Höffken K. Sustained expression of nucleophosmin (NPM1) mutation at late relapse presenting as isolated myeloid sarcoma in a patient with acute myeloid leukemia. Ann Hematol 2007; 86:763-5. [PMID: 17639390 DOI: 10.1007/s00277-007-0323-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2006] [Accepted: 01/02/2007] [Indexed: 10/23/2022]
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49
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Hmidi K, Zaouali S, Messaoud R, Mahjoub B, Ammari W, Bacha L, Laatiri A, Jenzeri S, Khairallah M. Bilateral orbital myeloid sarcoma as initial manifestation of acute myeloid leukemia. Int Ophthalmol 2007; 27:373-7. [PMID: 17522781 DOI: 10.1007/s10792-007-9088-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2006] [Accepted: 03/28/2007] [Indexed: 11/25/2022]
Abstract
BACKGROUND Granulocytic sarcoma is a rare orbital complication of acute leukemia. It concerns primarily children under 10 years of age suffering from primitive acute myeloid leukemia. The diagnosis is made by clinical examination, computed tomography and confirmed by haematological investigations. The treatment approach is based on chemotherapy associated with intravenous steroid therapy. CASE REPORT We report the case of a 6-year-old girl who presented with bilateral proptosis revealing acute myeloid leukemia. The patient was treated by a combination of chemotherapeutic drugs in two phases, associated with intravenous steroids. After a follow-up period of 24 months, the patient was in complete remission. CONCLUSION The diagnosis of granulocytic sarcoma should be considered in any orbital mass of uncertain origin, particularly if it is bilateral. Special stains and immunohistochemistry play an important role in the diagnosis.
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MESH Headings
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Child
- Drug Therapy, Combination
- Exophthalmos/etiology
- Female
- Glucocorticoids/therapeutic use
- Humans
- Leukemia, Myeloid, Acute/complications
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/drug therapy
- Orbital Neoplasms/diagnosis
- Orbital Neoplasms/drug therapy
- Orbital Neoplasms/etiology
- Sarcoma, Myeloid/diagnosis
- Sarcoma, Myeloid/drug therapy
- Sarcoma, Myeloid/etiology
- Tomography, X-Ray Computed
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Xie Z, Zhang F, Song E, Ge W, Zhu F, Hu J. Intraoral granulocytic sarcoma presenting as multiple maxillary and mandibular masses: a case report and literature review. ACTA ACUST UNITED AC 2007; 103:e44-8. [PMID: 17428693 DOI: 10.1016/j.tripleo.2006.12.028] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2006] [Revised: 11/12/2006] [Accepted: 12/21/2006] [Indexed: 10/23/2022]
Abstract
Granulocytic sarcoma (GS) is an unusual localized tumor composed of immature granulocytic precursor cells that occurs in extramedullary sites. However, GS involving the oral cavity is rare. We report a case of intraoral GS with an unusual clinical presentation, including a history of chronic myelogenous leukemia in remission, multiple maxillary and mandibular gingival masses mimicking acute inflammation that developed over a short period, complete remission after 1 week of treatment with imatinib mesylate (Gleevec), and no bone marrow or peripheral blood involvement over a 6-month follow-up period. To our knowledge, this is the first report of treatment of intraoral GS with Gleevec resulting in a complete remission.
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