Ocular Granulocytic Sarcoma: A Case Report and Literature Review of Ocular Extramedullary Acute Myeloid Leukemia

Ohanian, Maro; Borthakur, Gautam; Quintás‐Cardama, Alfonso; Mathisen, Michael S.; Cortés, Jorge E.; Estrov, Zeev; Pemmaraju, Naveen

doi:10.1016/j.clml.2012.07.008

Cited by 13 publications

(14 citation statements)

References 12 publications

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“…Although no blast cells were shown in the peripheral blood at the time of the biopsy, acute myeloid leukemia recurred, and the patient died. An eyelid myeloid sarcoma may be a sign of an incomplete remission of acute myeloid leukemia despite effective chemotherapy and poor prognosis [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although myeloid sarcoma can involve any ocular tissue, a myeloid sarcoma in the eyelid is less common [ 2 , 3 ]. Ocular myeloid sarcomas may appear at any time during the course of acute myeloid leukemia [ 3 , 4 ], and they often develop simultaneously with acute myeloid leukemia during onset or relapse [ 1 , 4 ]. In contrast, an ocular myeloid sarcoma that develops during chemotherapy is extremely rare, with only one reported case with an intraocular lesion [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Myeloid Sarcoma in an Eyelid That Developed during Chemotherapy for Acute Myeloid Leukemia

Kang

Takahashi

et al. 2016

Case Rep Ophthalmol

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An 80-year-old female presented with a mass in the left upper eyelid margin that had developed during chemotherapy for acute myeloid leukemia. The mass was elastic, hard, and pinkish, with a relatively smooth surface but without madarosis. The histopathological findings corresponded to a myeloid sarcoma. No blast cells were shown in the peripheral blood at the time of biopsy, and she subsequently underwent an azacitidine injection regimen. The size of the eyelid tumor decreased 3 months after the biopsy, when the course of azacitidine injections was completed. However, acute myeloid leukemia recurred, and the patient died 5 months after her first examination.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Myeloid Sarcoma in an Eyelid That Developed during Chemotherapy for Acute Myeloid Leukemia

Kang

Takahashi

et al. 2016

Case Rep Ophthalmol

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“…Clinical manifestations of AML are mainly driven by pancytopenia (anemia, leukopenia, and thrombocytopenia) and blast proliferation (some common signs and symptoms of AML are summarized in Table 1)[6,27,28]. At presentation, around 10% of patients have hyperleukocytosis (white blood cell [WBC] count > 100 × 10 9 /L)[6,29,30],[31].…”

Section: Clinical Manifestations Of Amlmentioning

confidence: 99%

Frontline treatment of acute myeloid leukemia in adults

Tamamyan

Kadia

Ravandi

et al. 2017

Critical Reviews in Oncology/Hematology

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117

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Recent years have highlighted significant progress in understanding the underlying genetic and epigenetic signatures of acute myeloid leukemia(AML). Most importantly, novel chemotherapy and targeted strategies have led to improved outcomes in selected genetic subsets. AML is a remarkably heterogeneous disease, and individualized therapies for disease-specific characteristics (considering patients’ age, cytogenetics, and mutations) could yield better outcomes. Compared with the historical 5-to 10-year survival rate of 10%, the survival of patients who undergo modern treatment approaches reaches up to 40–50%, and for specific subsets, the improvements are even more dramatic; for example, in acute promyelocytic leukemia, the use of all-trans retinoic acid and arsenic trioxide improved survival from 30–40% up to 80–90%. Similar progress has been documented in core-binding-factor-AML, with an increase in survival from 30% to 80% upon the use of high-dose cytarabine/fludarabine/granulocyte colony-stimulating factor combination regimens. AML treatment was also recently influenced by the discovery of the superiority of regimens with higher dose Ara-C and nucleoside analogues compared with the “7+3” regimen, with about a 20% improvement in overall survival. Despite these significant differences, most centers continue to use the “7+3” regimen, and greater awareness will improve the outcome. The discovery of targetable molecular abnormalities and recent studies of targeted therapies (gemtuzumab ozagomycin, FLT3 inhibitors, isocitrate dehydrogenase inhibitors, and epigenetic therapies), future use of checkpoint inhibitors and other immune therapies such as chimeric antigen receptor T-cells, and maintenance strategies based on the minimal residual disease evaluation represent novel, exciting clinical leads aimed to improve AML outcomes in the near future.

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“…[7][8][9] GS, most commonly see in the context of widespread and uncontrolled disease, may also be the first manifestation of AML, antedating it by months or years, or represent the initial manifestation of relapse in a patient previously treated for AML. 10,11 The risk factors for GS include specific chromosomal abnormalities, such as translocations between chromosomes 8 and 21 (t [8;21]) and…”

Section: Introductionmentioning

confidence: 99%

Isolated Granulocytic Sarcoma Of The Nasopharynx: A Case Report and Review Of The Literature

Chuda

Vishnu

Hwang

et al. 2013

Blood

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Granulocytic sarcoma (GS) is a rare extra medullary manifestation of acute myeloid leukemia (AML). It may also represent blastic transformation of myelodysplastic syndromes or myeloproliferative neoplasms. Although usually seen in the context of advanced and poorly controlled disease, it may also present as the first manifestation of illness, without concurrent bone marrow or blood involvement. In the medical literature chloroma and GS are terms that have been used interchangeably with myeloid sarcoma. GS usually manifest as soft tissue or bony masses in several extra cranial sites such as bone, periosteum and lymph nodes; involvement of the head and neck region is uncommon. Herein, we report a case of a 63 yearr-old woman with insidious onset of progressive nasal congestion and diminished hearing who was diagnosed with an isolated GS of the nasopharynx. With involved field radiotherapy she achieved a complete remission of 12 months duration before being diagnosed with overt AML. Following induction and consolidation chemotherapy she has remained disease free for now greater than 18 months. Through a MEDLINE®/PubMed® search we identified an additional 13 cases of nasopharyngeal GC. The median age was 37 years (range, 1 to 81 years). The cases were equally distributed among the sexes. The most common presenting symptoms were conductive hearing loss and sino-nasal congestion. Isolated GC was identified in 6 cases and the median time from diagnosis of GS to AML was 12 months (range, 3 to 48 months). Treatment varied, but responses were seen in all patients who received chemotherapy with or without radiotherapy.REFERENCE (YEAR)AGE (YEARS), SEXCLINICAL FEATURESASSOCIATED DIAGNOSISCYTOGENETICSOUTCOMEBassichis et al. (2000)1, maleMasseter muscleSynchronous AMLNot reported (NR)Died during chemotherapy.Au WY et al. (2001)37, maleConductive hearing loss, infiltrative nasopharyngeal massSolitary site of GSNormalInvolved field radiotherapy (IFRT) and chemotherapy. Complete remission (CR) at 3 years.Nayak et al.(2001)24, femaleBilateral parotid and nasopharyngeal massSolitary site of GSNRpatient died on 17th day of chemotherapy due to systemic infectionGeisse et al. (2002)60, maleWaldeyer’s ring lymphadenopathySynchronous MDSNRDiagnosis made on autopsyPrades et al.(2002)20, femaleSino-nasal obstruction; right maxillary and sphenoid sinus massGS of the nasal cavity and paranasal sinust(19:1)Allogeneic hematopoietic stem cell transplant (AHSCT) following chemotherapy; CR at 18 monthsOzcelik et al. (2003)37, maleVocal cord paralysis, involvement of 9th, 10th, 12th cranial nervesAML (M0) 6 months earlier - treated with chemotherapy to CRNRTreated with chemotherapy with partial regression of the nasopharyngeal masses; patient died on 17th day of chemotherapy due to pulmonary infectionSugimoto et al.(2004)31, femaleNasopharynx, external acoustic meatusAML (M2) 3 months earlier - treated with chemotherapy to CRt(8;21)(q22;q22)Achieved CR2 with IFRT, re-induction chemotherapy, followed by AHSCT.Imamura et al.(2004)7, femaleWaldeyer’s ring and cervical lymphadenopathySynchronous juvenile myelomonocytic leukemiat(9;12) (p22;q24.1)AHSCT following chemotherapy; CR at 3 yearsFerri et al. (2005)72, femaleRight facial swelling and fever; maxillo-ethmoidal massAML (M0) 1 year earlier – treated with hydroxyurea.NRBest supportive care only; died after 10 days of hospitalization.Teramoto et al.(2006)81, femalenaso-pharyngeal massDeveloped AML (M2) 1 year later.Complex genomic defects on cDNA microarrayRadiation therapy only for GS; chemotherapy for AML; died 6 months after diagnosis of AML.Selvarajan et al. (2008)25, maleDysphagia, hoarseness, facial nerve palsyAML (M2) 4 years earlier – treated with chemotherapy to CR followed by AHSCTt(8:21)Treated with chemotherapy but had systemic relapse 1 year laterCho et al. (2011)18, maleConductive hearing loss, infiltrative nasopharyngeal massSynchronous AMLRUNX1-RUNX1T1Recurrence after 7 months of chemotherapy; achieved CR2 with re-induction chemotherapy, followed by AHSCT.Mei et al. (2013)56, femaleLeft maxillary sinusSolitary site of GSNRSurgical resection followed by chemotherapy; CR at 4 months(Current) case63, femaleConductive hearing loss, infiltrative nasopharyngeal massDeveloped AML one year later.NormalRadiation therapy only for GS; chemotherapy for AML; CR at 18 months Disclosures: No relevant conflicts of interest to declare.

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Ocular Granulocytic Sarcoma: A Case Report and Literature Review of Ocular Extramedullary Acute Myeloid Leukemia

Cited by 13 publications

References 12 publications

Myeloid Sarcoma in an Eyelid That Developed during Chemotherapy for Acute Myeloid Leukemia

Myeloid Sarcoma in an Eyelid That Developed during Chemotherapy for Acute Myeloid Leukemia

Frontline treatment of acute myeloid leukemia in adults

Isolated Granulocytic Sarcoma Of The Nasopharynx: A Case Report and Review Of The Literature

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