CASE REPORT
Myeloid sarcoma associated with blast crisis in chronic myelogenous leukemia – Case Report
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1
Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
2
Independent Clinical Transplantology Unit, Medical University, Lublin, Poland
3
Chair of Internal Medicine and Department of Internal Medicine in Nursing, Medical University, Lublin, Poland
4
Department of Pathomorphology, Medical University, Lublin, Poland
Corresponding author
Agnieszka Szymczyk
MD, MSc, Department of Haematooncology and Bone Marrow Transplantation, Medical University,
Staszica 11, 20-081 Lublin, Poland
J Pre Clin Clin Res. 2016;10(2):136-139
KEYWORDS
ABSTRACT
Introduction:
Myeloid sarcoma (MS) is a rare extramedullary tumour which may precede or occur concomitantly with bone marrow involvement in acute myeloid leukemia, myelodysplastic syndrome, or blast crisis in chronic myeloproliferative disorder. Myeloid sarcoma is most commonly found in lymph nodes, skin, subcutaneous tissue and gums, while it is less common in bones, the retroperitoneal space and eye socket.
Case Report:
The case is reported of a 65-year-old woman with chronic myelogenous leukemia treated for about 20 years with hydroxyurea, 6-mercaptopurine and tyrosine-kinase inhibitors. During the treatment, the general condition of the patient progressively deteriorated, lymphadenopathy and splenomegaly worsened, and blast crisis was diagnosed. After the first cycle of induction chemotherapy, the patient’s lymph nodes were swollen and painful. One of the lymph nodes was subjected to histopathology, on the basis of which a diagnosis of MS was made. As the patient showed no response to the treatment, palliative care was initiated. Three months after the diagnosis of MS, the disease progressed. The patient died of infectious complications
Conclusions:
A diagnosis of MS, which is considered an adverse prognostic factor, significantly reduces the chances of remission and overall survival in patients with acute myelogenous leukemia or blast crisis inchronic myeloproliferative disorders. It seems that early confirmation of the diagnosis and initiation of the treatment adjusted to the patient’s clinical condition may improve the prognosis and increase the response rates.
REFERENCES (15)
1.
Burns A. Observation of surgical anatomy, in Head and Neck. London, England, Royce; 1811.
2.
King A. Case of chloroma. Monthly J Med. 1853; 17: 17.
3.
Dock G, Warthin AS. A new case of chloroma with leukemia. Trans Assoc Am Phys. 1904; 19(64): 115.
4.
Rappaprt H. Tumors of the hematopoietic system, in Atlas of tumor Pathology, Section III, Fasciale 8, Armed Forces Institute Pathology, Washington DC; 1967.
5.
Wąsik-Szczepanek E. Mięsak mieloidalny (MM) – występowanie, charakterystyka kliniczna. Acta Haematol Pol. 2008; 39(2): 191–196 (in Polish).
6.
Seifert R P, Bulkeley W, Zhang L, Menes M, Bui MM. A practical approach to diagnose soft tissue myeloid sarcoma preceding or coinciding with acute myeloid leukemia. Ann DiagnPathol. 2014; 18(4): 253–260.
7.
Jordan RC, Glenn L, Treseler PA, Regezi JA. Granulocytic sarcoma: case report with an unusual presentation and review of the literature. J Oral Maxillofac Surg. 2002; 60(10): 1206–1211.
8.
Meis JM, Butler JJ, Osborne BM, Manning JT. Granulocytic sarcoma in nonleukemic patients. Cancer 1998; 58(12): 2697–2709.
9.
Klco JM, Welch JS, Nguyen TT, Hurley MY, Kreisel FH, Hassan A, Lind AC, Frater JL. State of the art in myeloid sarcoma. Int J Lab Hematol. 2011; 33(6): 555–565.
10.
Sisack MJ, Dunsmore K, Sidhu-Malik N. Granulocytic sarcoma in the absence of myeloid leukemia. J Am Acad Dermatol. 1997; 37(2 Pt 2): 308–311.
11.
Campidelli C, Agostinelli C, Stitson R, Pileri SA. Myeloid sarcoma: extramedullary manifestation of myeloid disorders. Am J Clin Pathol. 2009; 132(3): 426–437.
12.
Rup E, Wielowieyska-Szybińska D, Sułowicz D, Sacha T, Wojas-Pelc A, Skotnicki A. Myeloidsarcoma – opis przypadku. Prz Dermatol. 2009; 96: 215–219 (in Polish).
13.
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. 2005; 46(7): 1081–1084.
14.
Yilmaz AF, Saydam G, Sahin F, Baran Y. Granulocytic sarcoma: a systematic review. Am J Blood Res. 2013; 3(4): 265–720.
15.
Raucci A, Fontanarosa A, Somma P, Bergaminelli C, Valente T, Rea G. Myeloid sarcoma of rib: An atypical isolated chest finding. Egyptian J Radiol Nucl Med. 2015; 46: 105–109.