Isolated granulocytic sarcoma of the small intestine successfully treated with chemotherapy and bone marrow transplantation

Abstract

Isolated primary granulocytic sarcoma is a rare disease that presents as an extramedullary tumor of myeloid lineage cells. Most patients subsequently develop acute myelogenous leukemia (AML) within a short period, and their prognosis is poor. Herein, we report the case of a 33-year-old woman with a primary isolated granulocytic sarcoma which originated in the small intestine. After she recovered from surgery, she received intensive chemotherapy equivalent to that for AML, followed by allogeneic bone marrow transplantation from an HLA-matched, unrelated donor. Four years after the transplantation, she remains in complete remission without graft-versus-host disease or any other symptoms. This case illustrates the effectiveness of our therapeutic strategy for isolated granulocytic sarcoma, not only with surgical resection of the tumor and intensive chemotherapy equivalent to that for AML, but also with allogeneic bone marrow transplantation, performed while no sign of AML is observed.

Successful Treatment of Bulky Granulocytic Sarcoma of the Retroperitoneum with High-Dose Chemotherapy and Autologous Peripheral Blood Stem Cell Transplantation

“…2 Several reports have stated that long-term relapse-free survival was achieved in response to allogeneic transplantation. 10,11 However, the graft-versus-leukemia effect, which is a major antitumor effect after allogeneic transplantation, may be less efficient at the extramedullary site when compared with the bone marrow. 12 Several studies have reported that extramedullary relapse occurred after allogeneic transplantation, 13 and extramedullary relapse appeared to be more common after allogeneic transplantation when compared with that after chemotherapy alone.…”

Isolated Myeloid Sarcoma of the Gastrointestinal Tract

“…In the absence of hematological disorders, 46-75% of patients are initially diagnosed with conditions other than MS; most often, the misdiagnosis is NHL (13,14). During differential diagnosis, it is necessary to also consider poorly differentiated cancers and melanoma, and it children, neuroblastoma, rhabdomyosarcoma, Ewing sarcoma and medulloblastoma (15 (17)(18)(19)(20)(21)(22)(23)(24).…”

Spinal Myeloid Sarcoma in Two Non-Leukemic Patients

“…Moreover, 66-88% of patients with an isolated granulocytic sarcoma will develop AML at a mean of 9-11 months after diagnosis (16). Granulocytic sarcoma most commonly occurs in the soft tissues of the skin and bone, soft tissue of the head and neck (frequently the orbits), lymph node; rare cases involve the heart or small intestines and less often in the central nervous system and spinal cord (17)(18)(19). Involvement of the central nervous system (CNS) is rare, and spinal cord compression by granulocytic sarcoma is even more rare (8,9).…”