Granulocytic sarcoma preceding acute leukemia.A report of six cases

Krause, John R.

doi:10.1002/1097-0142(197909)44:3<1017::aid-cncr2820440333>3.0.co;2-i

Cited by 207 publications

(83 citation statements)

References 18 publications

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“…(5-7) Their development can occur concomitantly, following, or rarely antedating the onset of these diseases (8). The most common locations include the skin, soft tissue, bone, periosteum and lymph nodes; however, numerous sites have been described.…”

Section: Introductionmentioning

confidence: 99%

Radiation Therapy for Chloroma (Granulocytic Sarcoma)

Bakst¹,

Wolden²,

Yahalom³

2011

International Journal of Radiation Oncology*Biology*Physics

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Purpose-Chloroma (granulocytic sarcoma) is a rare, extramedullary tumor of immature myeloid cells related to acute non-lymphocytic leukemia or myelodysplastic syndrome (MDS). Radiation therapy (RT) is often used in the treatment of chloromas; however, modern studies of RT are lacking. We reviewed our experience to analyze treatment response, disease control, and toxicity associated with RT in order to develop treatment algorithm recommendations for patients with chloroma.Materials/Methods-38 patients who underwent treatment for chloromas at our institution from 2/1990-6/2010 were identified and their medical records were reviewed and analyzed.Results-The majority of patients that presented with chloroma at the time of initial leukemia diagnosis (78%) have not received RT as it regressed after initial chemotherapy. Yet most patients that relapsed or remained with chloroma after chemotherapy are in the RT cohort (90%). 33 courses of RT were administered to 22 patients. Radiation sub-site breakdown was: 39% head and neck, 24% extremity, 9% spine, 9% brain, 6% genitourinary, 6% breast, 3% pelvis, and 3% genitourinary. Median dose was 20 (6-36) Gy. Kaplan-Meier estimates of progression free survival (PFS) and overall survival (OS) in the RT cohort were 39% and 43%, respectively at 5 years. At a median follow-up of 11 months since RT, only one patient developed progressive disease at the irradiated site and 4 patients developed chloromas at other sites. RT was well tolerated without significant acute or late effects, and provided symptom relief in 95% of cases. Conclusions-The majority of patients with chloromas were referred for RT when there was extramedullary progression, marrow relapse, or rapid symptom relief required. RT resulted in excellent local disease control and palliation of symptoms without significant toxicity. We recommend irradiating chloromas to at least 20 Gy, and propose 24 Gy in 12 fractions as an appropriate regimen.

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Section: Introductionmentioning

confidence: 99%

Radiation Therapy for Chloroma (Granulocytic Sarcoma)

Bakst¹,

Wolden²,

Yahalom³

2011

International Journal of Radiation Oncology*Biology*Physics

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“…Besides the common locations mentioned above, MS may involve any organ / system in the body [5]. In this case report, the tonsils were involved which is a rarity [6]. Diagnosing myeloid sarcoma of the head and neck region poses a big challenge, because of the low frequency of occurrence and the potential for almost any lineage of tumour to occur in this region.…”

Section: Discussionmentioning

confidence: 76%

Myeloid sarcoma, a rarity of the head and neck region - A case report

Krishnamoorthy

Lee²,

Adzman³

et al. 2017

IJMS

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Myeloid sarcoma is a rare disease, where a mass (tumour) of either myeloblasts or immature myeloid cells conglomerate in extramedullary anatomic sites. It may arise de-novo or it may present in association with acute myeloid leukemia. It can also occur in patients with myelodysplastic syndromes, myeloproliferative disorders, and as blast transformation in myeloproliferative neoplasia. Myeloid sarcoma of the head and neck area can pose a diagnostic challenge because of the low frequency of occurrence, and the vast diversity of tumours occurring from multiple lineages in this anatomic region. This can lead to a broad spectrum of various differential diagnoses. Therefore, a high index of suspicion is required when dealing with a possible case of myeloid sarcoma, as it is a time sensitive diagnosis with various diagnostic dilemmas. Here, we report an example, a case of tonsillar myeloid sarcoma. We wish to highlight the investigations that helped us procure this diagnosis in a timely manner.

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“…Clinically, it is the overgrowth of bone marrow-resident leukaemic blasts which receive most attention, yet the aberrant migration and extramedullary infiltration of secondary sites such as distal marrow, gums, meninges, skin and lungs by circulating blasts remains a major complicating factor (Stefanidakis et al, 2009;Voermans et al, 2002). Such migration can manifest as myeloid sarcoma in up to 10% of AML cases (Krause, 1979;Wiernik and Serpick, 1970), and leukaemic cutis in 3% of cases (Agis et al, 2002). When occurring as complications of AML, both conditions tend to present at the same time as the progression to systemic bone marrow leukaemia, and often at relapse stage suggesting that the opportunity to address this complication is in the early phases of the disease (Bakst et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

FLT3-driven redox-modulation of Ezrin regulates leukaemic cell migration

Corcoran

Cotter

2012

Free Radical Research

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Access to the full text of the published version may require a subscription. and ideas for this work, and who supported and believed in me throughout -I am grateful to have had the opportunity to learn from the best. I must also give a huge thank you to Kate Cotter, who made me feel at home from day one, and who has continued to be a tireless source of energy and assistance. RightsI was fortunate to interact with a vibrant, dynamic group in the Cotter Lab and I owe a huge thanks to every single member, past-Claire, Ruth, Carolyn, Chris, Ashley, To all the friends that I have made in U.C.C. and beyond during this process, as well as those friends lucky enough not to be involved but who still got to listen to all that whingeing-thank you! Lastly, I am most indebted to those closest to me. My mam -who is always ready to listen, comfort and reassure, and as a result probably knows more than she ever wanted to about cells and reactive oxygen species! My dad, a real scientist, who never stops teaching and never stops learning, and is still the person I turn to with my "homework" questions! I am so grateful to you both for your wisdom, encouragement and patience; truly I could not have achieved this without you. ToSinead and Dara, for all the much needed distractions and laughs, and for even being interested! And to John, for being there throughout, for the joy and the inspiration. To everyone still waiting for good news or the right medicine 'Happy is he who gets to know the reasons for things.' -Virgil DeclarationThis thesis has not been submitted in whole or in part to this or any other university for any degree and is, unless otherwise stated, the original work of the author. pathway may allow for combination therapies to be used to impede the emergence of resistance. However, the intracellular signal transduction pathway of FLT3 is relatively obscure. The objective of this study is to further elucidate this pathway, with particular focus on the redox signalling element which is thought to be involved. Signalling via reactive oxygen species is becoming increasingly recognised as a crucial aspect of physiological and pathological processes within the cell. The first part of this study examined the effects of NADPH oxidase-derived reactive oxygen species on the tyrosine phosphorylation levels of acute myeloid leukaemia cell lines. Using two-dimensional phosphotyrosine immunoblotting, a range of proteins were identified as undergoing tyrosine phosphorylation in response to iii NADPH oxidase activity. Ezrin, a cytoskeletal regulatory protein and substrate of Src kinase, was selected for further study.The next part of this study established that NADPH oxidase is subject to regulation by FLT3. Both wild type and oncogenic FLT3 signalling were shown to affect the expression of a key NADPH oxidase subunit, p22phox, and FLT3 was also demonstrated to drive intracellular reactive oxygen species production. The NADPH oxidase target protein, Ezrin, undergoes phosphorylation on two tyrosine residues downstream of FLT3 signalli...

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Granulocytic sarcoma preceding acute leukemia.A report of six cases

Cited by 207 publications

References 18 publications

Radiation Therapy for Chloroma (Granulocytic Sarcoma)

Radiation Therapy for Chloroma (Granulocytic Sarcoma)

Myeloid sarcoma, a rarity of the head and neck region - A case report

FLT3-driven redox-modulation of Ezrin regulates leukaemic cell migration

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