Myeliod sarcoma in cardio-phrenic angle after allogeneic peripheral blood stem cell transplantation

doi:10.3969/j.issn.2095-4344.2013.27.015

Abstract

Abstract:

BACKGROUND: Allogeneic hematopoietic stem cell transplantation is the main method to cure leukemia, but the patients receiving allogeneic hematopoietic stem cell transplantation still have to face the risk of recurrence. Myeloid sarcoma is a rare extramedullary relapse mode with worse clinical outcomes, so it is necessary to understand the characteristics of myeloid sarcoma and relative treatment methods.
OBJECTIVE: To analyze the clinical characteristics and treatment methods of myeliod sarcomas in cardio-phrenic angle after allogeneic peripheral blood stem cell transplantation.
METHODS: One case was diagnosed as single myeloid sacoma in the cardio-phrenic angle after allogeneic peripheral blood stem cell transplantation. The patient underwent surgical resection of the mass, chemotherapy and radiotherapy. The clinical effect, complications and survival situation were observed.
RESULTS AND CONCLUSION: The patient suffered from bacteremia, fungal pneumonia and even life-threatening sepsis shock during two courses chemotherapies. Then, the patient received radiotherapy for mediastinum and the myeloid sacoma never relapsed. However, the patient suffered central nervous system leukemia after free of the disease for 25 months. Myeliod sarcoma after allogeneic hematopoietic stem cell transplantation is rare and its manifestation is changeful. The diagnosis mainly depends on histopathology and immunohistochemistry. Surgery, chemotherapy, radiotherapy, second transplantation and molecular targeted
drugs are the choices of treatment strategy. However, the optimal treatment strategy for individual patients remains to be determined.

Key words: stem cells, stem cell transplantation, acute myeloid leukemia, allogeneic stem cell transplantation, myeliod sarcoma, cardio-phrenic angle, chemotherapy, radiotherapy, stem cell photogranphs-supporting paper

CLC Number:

R394.2

He Yi, Li Xu-dong, Wang Dong-ning, Hu Yuan, Wang Wen-wen, Liu Jia-jun, Lin Dong-jun, Huang Ren-wei. Myeliod sarcoma in cardio-phrenic angle after allogeneic peripheral blood stem cell transplantation[J]. Chinese Journal of Tissue Engineering Research, doi: 10.3969/j.issn.2095-4344.2013.27.015.

References

[1] Copelan EA. Hematopoietic stem-cell transplantation. N Engl J Med. 2006;354(17):1813-1826.

[2] Passweg JR, Baldomero H, Gratwohl A, et al. The EBMT activity survey: 1990-2010. Bone Marrow Transplant. 2012; 47(7):906-923.

[3] Chang YJ, Huang XJ. Donor lymphocyte infusions for relapse after allogeneic transplantation: when, if and for whom? Blood Rev. 2013;27(1):55-62.

[4] Zhao XS, Jin S, Zhu HH, et al. Wilms' tumor gene 1 expression: an independent acute leukemia prognostic indicator following allogeneic hematopoietic SCT. Bone Marrow Transplant. 2012;47(4):499-507.

[5] Itonaga H, Tsushima H, Taguchi J,et al.Treatment of relapsed adult T-cell leukemia/lymphoma after allogeneic hematopoietic stem cell transplantation: the Nagasaki Transplant Group experience. Blood. 2013;121(1):219-225.

[6] Wang Y, Liu DH, Liu KY,et al.Impact of Pretransplantation Risk Factors on Post Transplantation Outcome of Patients With Acute Myeloid Leukemia in Remission After Haploidentical hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transplant. 2013;19(2):283-290.

[7] Oran B, de Lima M. Prevention and treatment of acute myeloid leukemia relapse after allogeneic stem cell transplantation. Curr Opin Hematol. 2011;18(6):388-394.

[8] Vardiman JW, Thiele J, Arber DA, et al. The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes. Blood. 2009;114(5):937-951.

[9] Wang X,Liu H,Wu Z,et al. A case of acute promyelocytic leukemia presenting with a nonleukemic granulocytic sarcoma of the ovary, with subsequent development of acute myeloid leukemia associated with t(8;21). Leuk Res. 2009; 33(4):580-582.

[10] Ho T,Sedarat F,Rao N,et al.Diagnostic confusion resulting from CD56 expression by cutaneous myeloid sarcoma. Rare Tumors. 20098;1(2):e51.

[11] Isik P,Tavil B,Tunç B,et al.Extramedullary orbital granulocytic sarcoma without bone marrow involvement: a report of two cases. Pediatr Hematol Oncol. 2011;28(1): 65-70.

[12] Mansoor S,Nasir-Ud-Din,Azam M,et al.Generalized cutaneous granulocytic sarcoma with joint involvement. J Coll Physicians Surg Pak. 2010;20(5):339-340.

[13] Ghafoor T,Zaidi A,Al Nassir I.Granulocytic sarcoma of the small intestine: an unusual presentation of acute myelogenous leukaemia. J Pak Med Assoc. 2010;60(2): 133-135.

[14] Zhang XH,Zhang R,Li Y.Granulocytic sarcoma of abdomen in acute myeloid leukemia patient with inv(16) and t(6;17) abnormal chromosome: Case report and review of literature. Leuk Res. 2010;34(7):958-961.

[15] Lee DA,Harris CP,Gresik VM,et al.Granulocytic sarcoma presenting as pneumonia in a child with t(8;21) acute myelogenous leukemia: diagnosis by fluorescent in situ hybridization.J Pediatr Hematol Oncol. J Pediatr Hematol Oncol. 2004;26(7):431-434.

[16] Lo WP,Kuo CL,Kuo MT,et al.Isolated conjunctival myeloid sarcoma as a presenting sign of acute leukemia. Chang Gung Med J. 2010;33(3):334-337.

[17] Serefhanoglu S,Goker H,Aksu S,et al.Spinal myeloid sarcoma in two non-leukemic patients. Intern Med. 2010;49(22): 2493-2497.

[18] Tirado CA, Chen W, Valdez F, et al. Unusual presentation of myeloid sarcoma in a case of acute promyelocytic leukemia with a cryptic PML-RARA rearrangement involving multiple sites including the atrium. Cancer Genet Cytogenet. 2010; 200(1):47-53.

[19] Narayan P, Murthy V, Su M,et al.Primary myeloid sarcoma masquerading as an obstructing duodenal carcinoma. Case Rep Hematol. 2012;2012:490438.

[20] Gunaldi M, Kara IO, Duman BB, et al.Primary intracerebral myeloid sarcoma. Onkologie. 2012;35(11):694-697.

[21] Takahashi M, Matsukura T, Hirai T,et al.Surgical resection for isolated myeloid sarcoma arising from a rib. Ann Thorac Surg. 2012;94(5):e117-118.

[22] Mangla D, Dewan M, Meyer DR.Adult orbital myeloid sarcoma (granulocytic sarcoma): two cases and review of the literature. Orbit. 2012;31(6):438-440.

[23] Hodges G, Lai HC, Irving I, et al.Isolated intracranial myeloid sarcoma. Pathology. 2012;44(6):571-574.

[24] Rizwan M, Islam MM, Rehman ZU.Granulocytic sarcoma of the male breast in acute myeloblastic leukemia with concurrent deletion of 5q and trisomy 8. Case Rep Hematol. 2012;2012:194312.

[25] Cho SF, Liu TC, Chang CS.Isolated central nervous system relapse presenting as myeloid sarcoma of acute myeloid leukemia after allogeneic peripheral blood stem cell transplantation. Ann Hematol. 2013;92(1):133-135.

[26] Manning D, Palacios E, Neitzschman H.Recurrent pre-B-cell acute lymphoblastic leukemia in the middle ear: a form of granulocytic sarcoma. Ear Nose Throat J. 2012;91(7): 272-274.

[27] Nazer A, Al-Badawi I, Chebbo W,et al.Myeloid sarcoma of the vulva post-bone marrow transplant presenting as isolated extramedullary relapse in a patient with acute myeloid leukemia. Hematol Oncol Stem Cell Ther. 2012;5(2):118- 121.

[28] Gill H, Loong F, Mak V,et al.Myeloid sarcoma of the uterine cervix presenting as missed abortion. Arch Gynecol Obstet. 2012;286(5):1339-1341.

[29] Toumeh A, Phinney R, Kobalka P,et al.Bilateral myeloid sarcoma of the breast and cerebrospinal fluid as a relapse of acute myeloid leukemia after stem-cell transplantation: a case report. J Clin Oncol. 2012;30(22):e199-201.

[30] Mawad R, Wu D, Abkowitz JL,et al.Myeloid sarcoma of the heart. Leuk Lymphoma. 2012;53(12):2511-2514.

[31] Békássy AN, Hermans J, Gorin NC,et al. Granulocytic sarcoma after allogeneic bone marrow transplantation: a retrospective European multicenter survey. Acute and Chronic Leukemia Working Parties of the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant. 1996;17(5):801-808.

[32] Koc Y, Miller KB, Schenkein DP, et al.Extramedullary tumors of myeloid blasts in adults as a pattern of relapse following allogeneic bone marrow transplantation. Cancer. 1999;85(3): 608-615.

[33] Simpson DR, Nevill TJ, Shepherd JD, et al.High incidence of extramedullary relapse of AML after busulfan/cyclophosphamide conditioning and allogeneic stem cell transplantation. Bone Marrow Transplant. 1998;22(3): 259-264.

[34] Harris AC, Kitko CL, Couriel DR, et al.Extramedullary relapse of acute myeloid leukemia following allogeneic hematopoietic stem cell transplantation: incidence, risk factors and outcomes. Haematologica. 2013;98(2):179-184.

[35] Fritz J, Vogel W, Bares R,et al.Radiologic spectrum of extramedullary relapse of myelogenous leukemia in adults. AJR Am J Roentgenol. 2007;189(1):209-218.

[36] Ueda K, Ichikawa M, Takahashi M,et al.FDG-PET is effective in the detection of granulocytic sarcoma in patients with myeloid malignancy. Leuk Res. 2010;34(9):1239-1241.

[37] Aschoff P, Häntschel M, Oksüz M,et al.Integrated FDG-PET/CT for detection, therapy monitoring and follow-up of granulocytic sarcoma. Initial results. Nuklearmedizin. 2009; 48(5):185-191.

[38] Lee EY, Anthony MP, Leung AY, et al.Utility of FDG PET/CT in the assessment of myeloid sarcoma. AJR Am J Roentgenol. 2012;198(5):1175-1179.

[39] Stölzel F, Röllig C, Radke J,et al.18F-FDG-PET/CT for detection of extramedullary acute myeloid leukemia. Haematologica. 2011;96(10):1552-1556.

[40] Yoshihara S, Ando T, Ogawa H.Extramedullary relapse of acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation: an easily overlooked but significant pattern of relapse. Biol Blood Marrow Transplant. 2012; 18(12):1800-1807.

[41] Pileri SA,Ascani S,Cox MC,et al.Myeloid sarcoma: clinico-pathologic, phenotypic and cytogenetic analysis of 92 adult patients. Leukemia. 2007;21(2):340-350.

[42] Wojnar J, Giebel S, Ho?owiecka-Goral A, et al.Impact of chronic graft-versus-host disease on long-term outcome after allogeneic hematopoietic cell transplantation in adult acute lymphoblastic leukemia. Pol Arch Med Wewn. 2006;116(1): 671-677.

[43] Au WY, Chan AC, Lie AK,et al. Recurrent isolated extramedullary relapses as granulocytic sarcomas following allogeneic bone marrow transplantation for acute myeloid leukaemia. Bone Marrow Transplant. 1998;21(2):205-208.

[44] Owonikoko T, Agha M, Balassanian R, et al.Gemtuzumab therapy for isolated extramedullary AML relapse following allogeneic stem-cell transplant. Nat Clin Pract Oncol. 2007; 4(8):491-495.

[45] Solh M, DeFor TE, Weisdorf DJ,et al.Extramedullary relapse of acute myelogenous leukemia after allogeneic hematopoietic stem cell transplantation: better prognosis than systemic relapse. Biol Blood Marrow Transplant. 2012;18(1):106-112.

[46] Al Beihany A, Al Mohareb F, Al Zahrani H,et al.Leukemia relapse after allogeneic bone marrow transplantation: how does chronic graft-versus-host disease influence the pattern and onset of relapse? Exp Clin Transplant. 2011;9(6):432-433.

[47] Békássy AN, Hermans J, Gorin NC, et al. Granulocytic sarcoma after allogeneic bone marrow transplantation: a retrospective European multicenter survey. Acute and Chronic Leukemia Working Parties of the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant. 1996;17(5):801-808.

[48] Koc Y, Miller KB, Schenkein DP, et al. Extramedullary tumors of myeloid blasts in adults as a pattern of relapse following allogeneic bone marrow transplantation. Cancer. 1999;85(3): 608-615.

[49] Chevallier P, Mohty M, Lioure B,et al.Allogeneic hematopoietic stem-cell transplantation for myeloid sarcoma: a retrospective study from the SFGM-TC. J Clin Oncol. 2008; 26(30):4940-4943.

[50] Kai T, Kimura H, Shiga Y, et al.Recurrent extramedullary relapse of acute promyelocytic leukemia after allogeneic stem cell transplantation: successful treatment by arsenic trioxide in combination with local radiotherapy. Int J Hematol. 2006; 83(4):337-340.

[51] Kottaridis PD,Ketley N, Peggs K,et al.An unusual case of intrapulmonary granulocytic sarcoma presenting as interstitial pneumonitis following allogeneic bone marrow transplantation for acute myeloid leukaemia and responding to donor lymphocyte infusion. Bone Marrow Transplant. 1999;24(7): 807-809.

[52] Antic D, Elezovic I, Milic N,et al.Is there a "gold" standard treatment for patients with isolated myeloid sarcoma? Biomed Pharmacother. 2013;67(1):72-77.

[53] Slomowitz SJ, Shami PJ.Management of extramedullary leukemia as a presentation of acute myeloid leukemia. J Natl Compr Canc Netw. 2012;10(9):1165-1169.

[54] Shimizu H, Saitoh T, Tanaka M, et al. Allogeneic hematopoietic stem cell transplantation for adult AML patients with granulocytic sarcoma. Leukemia. 2012;26(12): 2469- 2473.

[55] Ando T, Mitani N, Matsunaga K, et al. Gemtuzumab ozogamicin therapy for isolated extramedullary AML relapse after allogeneic hematopoietic stem-cell transplantation. Tohoku J Exp Med. 2010;220(2):121-126.