Abstract
Isolated breast relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is less often seen. Chronic graft-versus-host disease (cGVHD) is effective in preventing marrow relapse, but cGVHD seems not to be effective extramedullary relapse (EMR). We report the case of isolated breast relapse after first allo-HSCT for acute lymphoblastic leukemia (ALL). A 47-year-old female was diagnosed with ALL achieved complete remission with salvage chemotherapy and underwent allo-HSCT from an HLA-matched sibling male donor. At 17 months post-transplant, she presented with a bilateral breast masses that confirmed the diagnosis lymphoblast involvement. She had no evidence of leukemia in her marrow that determined 100 % full-donor chimerism when she was relapsed in her both breasts.
This is a preview of subscription content, log in via an institution to check access.
References
Dermime S, Mavroudis D, Jiang YZ, Hensel N, Molldrem J, Barrett AJ (1997) Immune escape from a graft-versus-leukemia effect may play a role in the relapse of myeloid leukemias following allogeneic bone marrow transplantation. Bone Marrow Transplant 19:989–999
Miller JS, Warren EH, van den Brink MR, Ritz J, Shlomchik WD, Murphy WJ, Barrett AJ, Kolb HJ, Giralt S, Bishop, Blazar BR, Falkenburg JH (2010) NCI First International Workshop on the biology, prevention, and treatment of relapse after allogeneic hematopoietic stem cell transplantation: report from the Committee on the biology underlying recurrence of malignant disease following allogeneic HSCT: Graft-versus-tumor/leukemia reaction. Biol Blood Marrow Transplant 16:565–586
Firas AS, Demeckova E, Bojtarova E, Czako B, Hrubisko M, Mistrik M (2008) Isolated extra-medullary relapse of acute leukemia following allogeneic bone marrow transplantation. Bratisl Lek Listy 109:358–361
Shi JM, Meng XJ, Luo Y, Tan YM, Zhu XL, Zheng GF, He JS, Zheng WY, Xie WZ, Li L, Ye XJ, Zhang J, Cai Z, Lin MF, Huang H (2013) Clinical characteristics and outcome of isolated extramedullary relapse in acute leukemia after allogeneic stem cell transplantation: a single-center analysis. Leuk Res 37:372–377
Larson RA, Dodge RK, Linker CA, Stone RM, Powell BL, Lee EJ, Schulman P, Davey FR, Frankel SR, Bloomfield CD, George SL, Schiffer CA (1998) A randomized controlled trial of filgrastim during remission induction and consolidation chemotherapy for adults with acute lymphoblastic leukemia: CALGB study 9111. Blood 92(5):1556–1564
Specchia G, Pastore D, Carluccio P, Liso A, Mestice A, Rizzi R, Ciuffreda L, Pietrantuono G, Liso V (2005) FLAG-IDA in the treatment of refractory/relapsed adult acute lymphoblastic leukemia. Ann Hematol 84(12):792–795
Lee KH, Lee JH, Kim S, Lee JS, Kim SH, Kim WK (2000) High frequency of extramedullary relapse of acute leukemia after allogeneic bone marrow transplantation. Bone Marrow Transplant 26:147–152
Ge L, Ye F, Mao X, Chen J, Sun A, Zhu X, Qiu H, Jin Z, Miao M, Fu C, Ma X, Chen F, Xue S, Ruan C, Wu D, Tang X (2014) Extramedullary relapse of acute leukemia after allogeneic hematopoietic stem cell transplantation: different characteristics between acute myelogenous leukemia and acute lymphoblastic leukemia. Biol Blood Marrow Transplant 20:1040–1047
Cunningham I (2006) Extramedullary sites of leukemia relapse after transplant. Leuk Lymphoma 47:1754–1767
Cunningham I (2006) A clinical review of breast involvement in acute leukemia. Leuk Lymphoma 47:2517–2526
Lee KH, Lee JH, Choi SJ, Lee JH, Kim S, Seol M, Lee YS, Kim WK, Seo EJ, Park CJ, Chi HS, Lee JS (2003) Bone marrow versus extramedullary relapse of acute leukemia after allogeneic hematopoietic cell transplantation: risk factors and clinical course. Bone Marrow Transplant 32:835–842
Thanka J, Krishnarathinam K, Rajendiran S (2010) Extramedullary relapse of acute lymphoblastic leukemia in breast: a rare presentation. Indian J Pathol Microbiol 53:155–156
Fadilah SA, Goh KY (2009) Breast and ovarian recurrence of acute lymphoblastic leukaemia after allogeneic peripheral blood haematopoietic stem cell transplantation. Singap Med J 50:407–409
Shimoni A, Rand A, Hardan I et al (2008) Isolated extramedullary relapse of acute leukemia after allogeneic stem cell transplantation: different kinetics and better prognosis than systemic relapse. ASH Annual Meeting Abstracts. Blood. 112:2148
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 18:106–112
Poon LM, Hamdi A, Saliba R, Ledesma C, Kendrick M, Qazilbash M, Hosing C, Jones RB, Popat UR, Nieto Y, Alousi A, Ciurea S, Shpall EJ, Champlin RE, Kebriaei P (2013) Outcomes of adults with acute lymphoblastic leukemia relapsing after allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 19:1059–1064
Huang Q, Reddi D, Chu P, Snyder DS, Weisenburger DD (2014) Clinical and pathologic analysis of extramedullary tumors after hematopoietic stem cell transplantation. Hum Pathol 45:2404–2410
Conflict of interest
The authors report no declarations of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Demirsoy, E.T., Atesoglu, E.B., Tarkun, P. et al. Isolated Breast Relapse of Acute Lymphoblastic Leukemia After Allogeneic Hematopoietic Stem Cell Transplantation. Indian J Hematol Blood Transfus 32 (Suppl 1), 201–204 (2016). https://doi.org/10.1007/s12288-015-0560-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12288-015-0560-z