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CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2013; 34(02): 111-113
DOI: 10.4103/0971-5851.116195
CASE REPORT

Management of isolated recurrence of extramedullary myeloid tumor at a single site

Muddu Vamshi Krishna
Department of Medical Oncology, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
,
Ashok K. Yadav
Department of Medical Oncology, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
,
Brijesh Arora
Department of Medical Oncology, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
,
Shripad D. Banavali
Department of Medical and Pediatric Oncology, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
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Abstract

Extramedullary myeloid tumors (EMMT) can precede, occur with or follow AML. Rarely, they can present as isolated relapses. We present a 9-year-old child with t (8, 21) positive AML who was treated with induction regimen and achieved remission. While on high-dose cytarabine consolidation, he had isolated relapse in a single cervical lymph node with uninvolved marrow. He was treated with salvage chemotherapy alone. There are no clear guidelines for treatment of isolated extramedullary relapse. Chemotherapy, radiotherapy followed by stem cell transplant is the usual option. Our patient is unique for the unusual site of relapse and prolonged remission with cladribine-based chemotherapy, mitoxantrone-based consolidation, and oral maintenance therapy.

Keywords

2-CDA - AML - chemotherapy - extramedullary relapse


Publication History

Article published online:
20 July 2021

© 2013. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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  • References

  • 1 Bakst R, Jakubowski A, Yahalom J. Recurrent neurotropic chloroma: Report of a case and review of the literature. Adv Hematol 2011;2011:854240.
  • 2 Paydas S, Zorludemir S, Ergin M. Granulocytic sarcoma: 32 cases and review of the literature. Leuk Lymphoma 2006;47:2527-41.
  • 3 Byrd JC, Edenfield WJ, Shields DJ, Dawson NA. Extramedullary myeloid cell tumors in acute nonlymphocytic leukemia: A clinical review. J Clin Oncol 1995;13:1800-16.
  • 4 Rubnitz JE, Crews KR, Pounds S, Yang S, Campana D, Gandhi VV, et al. Combination of cladribine and cytarabine is effective for childhood acute myeloid leukemia: Results of the St Jude AML97 trial. Leukemia 2009;23:1410-6.
  • 5 Chang H, Brandwein J, Yi QL, Chun K, Patterson B, Brien B. Extramedullary infiltrates of AML are associated with CD56 expression, 11q23 abnormalities and inferior clinical outcome. Leuk Res 2004;28:1007-11.
  • 6 Byrd JC, Weiss RB. Recurrent granulocytic sarcoma. An unusual variation of acute myelogenous leukemia associated with 8;21 chromosomal translocation and blast expression of the neural cell adhesion molecule. Cancer 1994;73:2107-12.
  • 7 Békássy AN, Hermans J, Gorin NC, Gratwohl A. Granulocytic sarcoma after allogeneic bone marrow transplantation: A retrospective European multicenter survey. Acute and Chronic Leukemia Working Parties of the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant 1996;17:801-8.
  • 8 Ghadiany M, Attarian H, Hajifathali A, Khosravi A, Molanaee S. Relapse of acute myeloid leukemia as isolated bilateral testicular granulocytic sarcoma in an adult. Urol J 2008;5:132-5.
  • 9 Koc Y, Miller KB, Schenkein DP, Daoust P, Sprague K, Berkman E. Extramedullary tumors of myeloid blasts in adults as a pattern of relapse following allogeneic bone marrow transplantation. Cancer 1999;85:608-15.
  • 10 Price SL, Lancet JE, George TJ, Wetzstein GA, List AF, Ho VQ, et al. Salvage chemotherapy regimens for acute myeloid leukemia: Is one better? Efficacy comparison between CLAG and MEC regimens. Leuk Res 2011;35:301-4.
  • 11 Martin MG, Welch JS, Augustin K, Hladnik L, DiPersio JF, Abboud CN. Cladribine in the treatment of acute myeloid leukemia: A single-institution experience. Clin Lymphoma Myeloma 2009;9:298-301.
  • 12 Wierzbowska A, Robak T, Pluta A, Wawrzyniak E, Cebula B, Ho³owiecki J, et al . Cladribine combined with high doses of arabinoside cytosine, mitoxantrone, and G-CSF (CLAG-M) is a highly effective salvage regimen in patients with refractory and relapsed acute myeloid leukemia of the poor risk: A final report of the Polish Adult Leukemia Group. Eur J Haematol 2008;80:115-26.
  • 13 Creutzig U, Zimmermann M, Bourquin JP, Dworzak MN, von Neuhoff C, Sander A, et al. Second induction with high-dose cytarabine and mitoxantrone: Different impact on pediatric AML patients with t (8; 21) and with inv (16). Blood 2011;118:5409-15.
  • 14 Banavali S, Singh R, Prasad M, Arora B, Nahar A, Vora T, et al. Is there a role for a novel maintenance therapy in pediatric patients with acute myeloid leukaemia. Pediatr Blood Cancer 2011;57:770 (Abs. PB 015).