Advertisement

Annals of Hematology

, Volume 92, Issue 1, pp 133–135 | Cite as

Isolated central nervous system relapse presenting as myeloid sarcoma of acute myeloid leukemia after allogeneic peripheral blood stem cell transplantation

  • Shih-Feng Cho
  • Ta-Chih Liu
  • Chao-Sung ChangEmail author
Letter to the Editor

Dear Editor,

A 27-year-old female had acute myeloid leukemia (AML), M4 of French–American–British (FAB) classification with cytogenetic abnormalities of inversion (16) and trisomy 8. Immunophenotyping was positive for CD33, CD13, CD15, CD11b, CD34, and HLA-DR. She achieved complete remission after induction chemotherapy (idarubicin 12 mg/m2/day for 3 days and cytarabine 200 mg/m2/day for 7 days) and four courses of consolidation therapy (cytarabine 3 g/day over 5 days). After 4 months, she had a relapse, with 60 % blast cells in the bone marrow, and received salvage chemotherapy (mitoxantron 12 mg/m2/day for 3 days and etoposide 100 mg/m2/day for 3 days) and again achieved complete remission. She underwent allogeneic peripheral blood stem cell transplantation (PBSCT) from an HLA-matched, related female donor with a conditioning regimen of cyclophosphamide (60 mg/kg/day for 2 days), etoposide (60 mg/kg for 1 day), and 12 Gy total body irradiation. Prophylaxis for graft-versus-host...

Keywords

Acute Myeloid Leukemia Peripheral Blood Stem Cell Transplantation Bone Marrow Examination Central Nervous System Relapse Myeloid Sarcoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflict of interest

The author(s) declare that they have no potential conflicts of interest.

References

  1. 1.
    Pileri SA, Ascani S, Cox MC et al (2007) Myeloid sarcoma: clinicopathologic, phenotypic and cytogenetic analysis of 92 adult patients. Leukemia 21(2):340–350. doi: 10.1038/sj.leu.2404491 PubMedCrossRefGoogle Scholar
  2. 2.
    Maeng H, Cheong JW, Lee ST et al (2004) Isolated extramedullary relapse of acute myelogenous leukemia as a uterine granulocytic sarcoma in an allogeneic hematopoietic stem cell transplantation recipient. Yonsei Med J 45(2):330–333PubMedGoogle Scholar
  3. 3.
    Solh M, DeFor TE, Weisdorf DJ, Kaufman DS (2012) Extramedullary relapse of acute myelogenous leukemia after allogeneic hematopoietic stem cell transplantation: better prognosis than systemic relapse. Biol Blood Marrow Transplant 18(1):106–112. doi: 10.1016/j.bbmt.2011.05.023 PubMedCrossRefGoogle Scholar
  4. 4.
    Oshima K, Kanda Y, Yamashita T et al (2008) Central nervous system relapse of leukemia after allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 14(10):1100–1107. doi: 10.1016/j.bbmt.2008.07.002 PubMedCrossRefGoogle Scholar
  5. 5.
    Cunningham I (2006) Extramedullary sites of leukemia relapse after transplant. Leuk Lymphoma 47(9):1754–1767. doi: 10.1080/10428190600632857 PubMedCrossRefGoogle Scholar
  6. 6.
    Lee KH, Lee JH, Choi SJ et al (2003) Bone marrow vs. extra-medullary relapse of acute leukemia after allogeneic hematopoietic cell transplantation: risk factors and clinical course. Bone Marrow Transplant 32(8):835–842. doi: 10.1038/sj.bmt.17042231704223 PubMedCrossRefGoogle Scholar
  7. 7.
    Chong G, Byrnes G, Szer J, Grigg A (2000) Extramedullary relapse after allogeneic bone marrow transplantation for haematological malignancy. Bone Marrow Transplant 26(9):1011–1015. doi: 10.1038/sj.bmt.1702659 PubMedCrossRefGoogle Scholar
  8. 8.
    Byrd JC, Edenfield WJ, Shields DJ, Dawson NA (1995) Extramedullary myeloid cell tumors in acute non-lymphocytic leukemia: a clinical review. J Clin Oncol 13(7):1800–1816PubMedGoogle Scholar
  9. 9.
    Markoc F, Bozdogan N, Yukruk FA, Gumuc EB, Akdur NC (2010) Granulocytic sarcomas: difficulties in diagnosis. Tumori 96(1):149–153PubMedGoogle Scholar
  10. 10.
    Khan F, Agarwal A, Agrawal S (2004) Significance of chimerism in hematopoietic stem cell transplantation: new variations on an old theme. Bone Marrow Transplant 34(1):1–12. doi: 10.1038/sj.bmt.17045251704525 PubMedCrossRefGoogle Scholar
  11. 11.
    Koc Y, Miller KB, Schenkein DP, Daoust P, Sprague K, Berkman E (1999) Extramedullary tumors of myeloid blasts in adults as a pattern of relapse following allogeneic bone marrow transplantation. Cancer 85(3):608–615. doi: 10.1002/(SICI)1097-0142(19990201)85:3<608::AID-CNCR11>3.0.CO;2-5 PubMedCrossRefGoogle Scholar
  12. 12.
    Frassoni F, Barrett AJ, Granena A et al (1988) Relapse after allogeneic bone marrow transplantation for acute leukaemia: a survey by the E.B.M.T. of 117 cases. Br J Haematol 70(3):317–332PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Shih-Feng Cho
    • 1
    • 2
  • Ta-Chih Liu
    • 1
    • 3
  • Chao-Sung Chang
    • 1
    • 4
    Email author
  1. 1.Division of Hematology and Oncology, Department of Internal MedicineKaohsiung Medical University HospitalKaohsiungTaiwan
  2. 2.Kaohsiung Medical UniversityKaohsiungTaiwan
  3. 3.Institute of Clinical Medicine, College of MedicineKaohsiung Medical UniversityKaohsiungTaiwan
  4. 4.Graduate institute of Healthcare AdministrationKaohsiung Medical UniversityKaohsiungTaiwan

Personalised recommendations