Successful treatment of primary granulocytic sarcoma by non-myeloablative stem cell transplant

Tan, Daryl; Wong, Gee-Chuan; Koh, Liang Piu; Hwang, William Ying Khee; Loh, Yvonne; Linn, Yeh-Ching; Goh, Yeow Tee

doi:10.1080/10428190500301140

Cited by 15 publications

(6 citation statements)

References 16 publications

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“…More aggressive modalities such as allogeneic HSCT are alternative strategies for isolated MS. In previous studies, the mean disease-free survival time of 12 patients who received allogeneic or autologous HSCT was reported to be 27.3 months (12–48 mo) [ 27 28 29 ]. Our patient underwent allogeneic HSCT from a human leukocyte antigen (HLA)-matched sibling donor, in addition to surgery and intensive chemotherapy, and remains disease-free after 18 months.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and treatment outcomes of isolated myeloid sarcoma without bone marrow involvement: a single-institution experience

et al. 2017

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BackgroundIsolated myeloid sarcoma (MS) is a rare extramedullary tumor mass composed of malignant myeloid precursor cells without any evidence of leukemia in the peripheral blood and bone marrow. We describe the clinical characteristics and outcomes of patients diagnosed with isolated MS at our institution.MethodsWe retrospectively reviewed 9 of 497 acute myeloid leukemia (AML) patients (1.8%) with isolated MS. Isolated MS patients were divided into 2 groups according to the first-line treatment strategy: systemic treatment only (S) or local treatment with or without systemic treatment (LS).ResultsThe most common site of MS occurrence was the head and neck area (N=4, 44.4%), followed by the anterior mediastinum (N=2, 22.2%) and the gastrointestinal tract (N=2, 22.2%). The tumors of 4 patients (44.4%) eventually evolved to AML, in a median time of 13.4 months (range, 2.4–20.1 mo). The number of patients achieving complete remission after first-line treatment was higher in the LS group (N=5, 83.3%) than in the S group (N=1, 33.3%) (P =0.226). All patients in the LS group survived, but those in the S group died (P=0.012).ConclusionAccurate and rapid diagnosis using various modalities and the early initiation of intensive combined treatment may be the optimal strategies to reduce the risk of isolated MS subsequently evolving to AML. To fully understand the characteristics of isolated MS, a larger number of patients from a multinational study is necessary.

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics and treatment outcomes of isolated myeloid sarcoma without bone marrow involvement: a single-institution experience

et al. 2017

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“…2 Histology of the surgical specimen demonstrated diffuse infiltration of medium to large cells with conspicuous nucleoli. a HE staining, b immunohistochemical staining of CD34, and c myeloperoxidase staining publication [6,[13][14][15][16][17][18][19]. Their mean disease-free survival period was reported to be 27.3 months (12-48 months) after stem cell transplantation.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2008

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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.

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“…While there are no prospective trials evaluating the role of BMT/HSCT in primary GS, some retrospective studies have shown good results with a 5-year survival rate of 48% and even encourage considering allogenic BMT/HSCT after the patients’ first induction of remission. [ 53 – 55 ]…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and management of primary granulocytic sarcoma of the oral cavity

Hu¹,

Deng²,

Wei³

et al. 2020

Medicine

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Introduction: Granulocytic sarcoma (GS) is a commonly occurring tumor comprising immature myeloid cells, which are usually related to acute or chronic myelocytic leukemia. The tumor rarely precedes leukemia without bone marrow involvement and is called primary GS. Although primary GS can occur in any body part, the involvement of the oral cavity is uncommon. Patient concerns: A 49-year-old woman hospitalized at the Department of Plastic and Maxillofacial Surgery presented with a growing mass in her left maxillary hard palate dating two months back. No obvious physical findings were noted during general examination. She was diagnosed with an oral ulcer at a local clinic, and received antibiotics. However, the symptoms did not improve; the mass became bigger and painful. Diagnosis: An incisional biopsy of the oral mass was performed, the immunohistochemistry showed that the tumor cells tested positive for myeloperoxidase, CD4, BCL-2, KI-67. Bone marrow aspiration was negative for malignant cells, and the laboratory test results revealed only monocytosis. Standard bone marrow cytogenetic analysis showed a normal karyotype and leukemia-related fusion gene detection was normal. Therefore, the final diagnosis was intraoral primary GS. Interventions: The patient was treated with a chemotherapy regimen based on idarubicin and cytarabine arabinoside. Outcomes: After 2 cycles of idarubicin and cytarabine arabinoside regimen chemotherapy, the patient achieved complete remission. The tumor was barely visible in the left maxillary hard palate. There has been no evidence of disease spread and progression after 1 year of follow-up. Conclusions: Careful morphological and immunohistochemical analyses, correlating with clinical data are necessary to establish the diagnosis of oral primary GS. Early aggressive systemic chemotherapy can effectively relieve symptoms, significantly reducing primary GS conversion into acute myelocytic leukemia and prolonging overall survival.

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Successful treatment of primary granulocytic sarcoma by non-myeloablative stem cell transplant

Cited by 15 publications

References 16 publications

Clinical characteristics and treatment outcomes of isolated myeloid sarcoma without bone marrow involvement: a single-institution experience

Clinical characteristics and treatment outcomes of isolated myeloid sarcoma without bone marrow involvement: a single-institution experience

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

Clinical characteristics and management of primary granulocytic sarcoma of the oral cavity

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