Acute myeloid leukemia with concurrent myeloid sarcoma treated with autologous bone marrow transplantation: two illustrative cases and a literature review

Abstract

Myeloid sarcoma (MS) is an invasive extramedullary solid tumor composed of immature cells of the myeloid series. It complicates the clinical course of a minority of patients with acute myeloid leukemia (AML). Traditionally its presence has been regarded as an indicator of aggressive disease. Currently, the optimal treatment of AML with concurrent MS remains to be determined. We report two cases of autologous bone marrow transplantation (auto-BMT) for AML with concurrent MS followed by a review of the literature.

Myeloid sarcoma: clinico-pathologic, phenotypic and cytogenetic analysis of 92 adult patients

“…Notably, the subjects treated with Auto/AlloBMT corresponded to long survivors, whereas those who received conventional therapies most often rapidly died of disease (OS at 48 months: 76 vs 0%; see Figure 3). Although not based on a randomized clinical trial, our study provides robust support to the recent concept -based on anecdotal observations 5,15,41 -that patients with MS should undergo high-dose therapies as front-line approach. The latter seems to represent the only chance to achieve CR and to possibly cure the disease.…”

“…1,4,5,12,40,41 However, recent studies suggest that either highly specific drugs 42 or aggressive schedules should also be applied to the latter, if one aims to achieve stable remission and cure. 5,14,15 So far, no definitive conclusion has been drawn concerning MS optimal treatment.…”

Myeloid sarcoma: current approach and therapeutic options

“…The role of auto-SCT in adults with MS is even less clear and there are no published case series. The results in case reports have variable outcomes, probably reflecting the difference in prognostic factors in each case [Finnegan et al 2005].…”

Vancomycin resistant enterococcus bacteremia in a patient with pneumocystis jiroveci pneumonia, granulocystic sarcoma and acute respiratory distress syndrome

“…It is common in children and adolescents and equally shown in both genders. This is a sign of bad prognosis [1]. Surgical excision, combined chemotherapy, and radiotherapy are treatment models [2].…”

“…Surgical excision, combined chemotherapy, and radiotherapy are treatment models [2]. Allogenic or autologous bone marrow transplantation are additional treatment to systemic chemotherapy in case of coexistence of acute leukemia and granulocytic sarcomae [1]. Recently immunosuppressed cases have increased due to an increment in cytotoxic and corticosteroid treatment (organ transplantation, systemic disorders, etc.)…”