We report herein two cases of leukemia cutis. One case is a 54-year-old woman who came to our department with complaints of a solitary ulcerating nodule on her left leg that had been present for 2 months since prior to her visit. Through histopathological studies, the diagnosis of myelocytic leukemia cutis was made before the final diagnosis of acute myelocytic leukemia was made by hematological studies. When combined chemotherapy was finished, she was in a partial remission state and the nodule disappeared after 1 month of chemotherapy. The other case is a 77-year-old man having multiple infiltrative nodules on the right forearm and right thigh for 1 month prior his visit. He was diagnosed as having leukemia cutis for his skin lesions histopathologically. This was redefined as chronic myelomonocytic leukemia of the myelodysplastic syndrome with blastic transfor- mation by hematological examination. He developed septicemia and died 3 weeks after the dermato- logical diagnosis.
Aged ; Diagnosis ; Drug Therapy ; Female ; Forearm ; Humans ; Leg ; Leukemia* ; Leukemia, Myeloid ; Leukemia, Myeloid, Acute ; Leukemia, Myelomonocytic, Chronic ; Logic ; Middle Aged ; Myelodysplastic Syndromes ; Sepsis ; Skin ; Thigh ; Ulcer

Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid, Chronic-Phase ; drug therapy ; Protein-Tyrosine Kinases ; antagonists & inhibitors

Humans ; Leukemia, Myeloid, Acute/therapy* ; Acute Disease ; Chronic Disease ; Recurrence ; China

Antineoplastic Agents ; Dasatinib ; Humans ; Leukemia, Myeloid, Chronic-Phase/drug therapy* ; Protein Kinase Inhibitors ; Pyrimidines/therapeutic use*

During the neutropenic phase, leukemia patients receiving chemotherapy are prone to bacterial and, fungal infections; occasionally mycobacterial, viral and protozoal organisms may also cause infections. Mycobacterium tuberculosis infection was reported very rarely in these patients. This report describes four patients with M. tuberculosis infection identified from 185 adult patients who were diagnosed myelogenous leukemia between January 2003, and December 2004. There was no patient with M. tuberculosis infection from 44 lymphoid leukemia and 11 acute biphenotypic leukemia patients. Sites of infection were all lymph nodes. Three among four patients were presented with lymphadenopathy at initial diagnosis of leukemia, and the other one presented with lymphadenopathy after induction chemotherapy. There was no patient presented with lymphadenopathy during the neutropenic phase. Tuberculous lymphadenitis was presented in a patient with three acute myelogenous leukemia (FAB class 2 M4, 1 M2) and a chronic myelogenous leukemia, accelerated phase. An acute myelogenous leukemia patient had a leukemic cell and tubercle bacilli in the same lymph node. Tuberculosis should also be included as a differential diagnosis in myelogenous leukemia patient with lymphadenopathy, especially in the countries in which the disease is endemic.
Adult ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Humans ; Induction Chemotherapy ; Leukemia ; Leukemia, Biphenotypic, Acute ; Leukemia, Lymphoid ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid* ; Leukemia, Myeloid, Acute ; Lymph Nodes ; Lymphatic Diseases ; Mycobacterium tuberculosis ; Tuberculosis ; Tuberculosis, Lymph Node*

During the neutropenic phase, leukemia patients receiving chemotherapy are prone to bacterial and, fungal infections; occasionally mycobacterial, viral and protozoal organisms may also cause infections. Mycobacterium tuberculosis infection was reported very rarely in these patients. This report describes four patients with M. tuberculosis infection identified from 185 adult patients who were diagnosed myelogenous leukemia between January 2003, and December 2004. There was no patient with M. tuberculosis infection from 44 lymphoid leukemia and 11 acute biphenotypic leukemia patients. Sites of infection were all lymph nodes. Three among four patients were presented with lymphadenopathy at initial diagnosis of leukemia, and the other one presented with lymphadenopathy after induction chemotherapy. There was no patient presented with lymphadenopathy during the neutropenic phase. Tuberculous lymphadenitis was presented in a patient with three acute myelogenous leukemia (FAB class 2 M4, 1 M2) and a chronic myelogenous leukemia, accelerated phase. An acute myelogenous leukemia patient had a leukemic cell and tubercle bacilli in the same lymph node. Tuberculosis should also be included as a differential diagnosis in myelogenous leukemia patient with lymphadenopathy, especially in the countries in which the disease is endemic.
Adult ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Humans ; Induction Chemotherapy ; Leukemia ; Leukemia, Biphenotypic, Acute ; Leukemia, Lymphoid ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid* ; Leukemia, Myeloid, Acute ; Lymph Nodes ; Lymphatic Diseases ; Mycobacterium tuberculosis ; Tuberculosis ; Tuberculosis, Lymph Node*

Antineoplastic Agents/therapeutic use* ; Dasatinib/therapeutic use* ; Humans ; Leukemia, Myeloid, Chronic-Phase/drug therapy* ; Prognosis ; Protein Kinase Inhibitors ; Treatment Outcome

Granulocytic sarcoma is an uncommon tumor composed of immature cells of the granulocytic series, occurring in patients with acute myelogenous leukemia and blast crisis of chronic myelogenous leukemia. It may be rarely preceded by an acute myelogenous leukemia and follows an unformly fatal course. We report a case of granulocytic sarcoma of extradural space presenting as the spinal cord compression without any evidence of leukemia in the peripheral blood. The tumor was located extraduraly in the C6-C7 area compressing the dural sac and spinal cord. After left hemilaminectomy of C6 and C7, this mass was removed completely. Postoperatively, symptoms and signs were improved. At the postoperative 10th day, the patient lost consciousness and peripheral blood study showed the findings of acute myelogenous leukemia. Thereafter, the patient received chemotherapy with Ara-C and Daunorubicin, but hematologic remission was not obtained completely. After 4 months, he revisited our hospital owing to fever, and the septic shock was encountered. The patient died of sepsis.
Blast Crisis ; Consciousness ; Cytarabine ; Daunorubicin ; Drug Therapy ; Fever ; Humans ; Leukemia ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid, Acute ; Sarcoma, Myeloid* ; Sepsis ; Shock, Septic ; Spinal Cord ; Spinal Cord Compression ; Spine*

The aim of this study was to investigate the effect of nonmyeloablative peripheral blood stem cell transplantation in treatment of chronic myeloid leukemia in chronic phase (CML-CP) and accelerated phase (CML-AP). 24 patients with CML including 16 in CML-CP and 8 in CML-AP were treated with nonmyeloablative conditioning regimen for peripheral blood stem cell transplantation (PBHSCT). The conditioning regimen included fludarabine (30 mg/m(2)x6 d), busulphan [4 mg/(kg.d)x2 d] and CTX [350 mg/(m2.d)x2 d] combined with or without Ara-C. The donors were HLA-identical (n=20) and 5/6 antigen-matched (n=4). The dynamic observation of hematopoietic recovery in all patients was carried out. The results indicated that all the patients were successfully engrafted. The mean time for increase of the number of neutrophils to more than 0.5x10(9)/L and platelet more than 20x10(9)/L were 13 days and 11.5 days respectively. Out of 12 patients, 9 patients showed complete donor chimerism and 3 patients showed mixed chimerism at 30 days after transplantation. At 180 days after transplantation, 18 survival patients showed complete donor chimerism. 18 patients remained alive after a median follow-up length of 24 months (4-48 months). 2 cases died of severe acute GVHD and 1 case died of chronic GVHD, 2 cases died of interstitial pneumonia and 1 case died of relapsed. In conclusions, nonmyeloablative peripheral blood stem cell transplantation is an effective therapeutic method for CML patients in chronic phase and accelerated phase.
Adult ; Female ; Graft vs Host Disease ; prevention & control ; Humans ; Leukemia, Myeloid, Accelerated Phase ; therapy ; Leukemia, Myeloid, Chronic-Phase ; therapy ; Male ; Middle Aged ; Peripheral Blood Stem Cell Transplantation ; methods ; Transplantation Conditioning

BACKGROUND: Donor leukocyte infusion (DLI) is an effective therapy for patients who relapse with leukemia after allogeneic bone marrow transplantation (BMT). This is due to the fact that the immune reactivity of infused allogeneic lymphocytes on relapsed leukemia cells plays a major role in the control of leukemia. However, severe graft-versus-host disease (GVHD) and pancytopenia compromise the success of this treatment in a substantial number of patients. METHODS: To evaluate the effect of DLI, we surveyed 6 BMT centers regarding their use of DLI for relapsed leukemia after BMT. Detailed forms were used to gather data regarding the original BMT, relapse, response to DLI, complication and survival. Reports of 11 patients were consequently available for analysis. RESULTS: Five (83.3%) of 6 patients with chronic myeloid leukemia (CML) achieved complete remission (CR) [time-to-CR; 116 (27~180) days after DLI], and currently 4 are alive in CR (49~436 days). Five patients (83.3%) developed GVHD, and 2 developed pancytopenia which was related to DLI. In acute leukemia, all patients received salvage chemotherapy prior to DLI. Only 1 of 3 patients with acute lymphoblastic leukemia (ALL) who had early relapse achieved CR, but durable remission was not yet confirmed (62+ days). Both 2 patients with acute myeloid leukemia (AML) achieved CR, and their CR durations were 242+ and 326 days after DLI, respectively. CONCLUSION: This study demonstrates that DLI can exert considerable effects against myeloid forms of leukemia, especially in CML. Further investigations of separating GVHD from the graft- versus-leukemia effect and finding more effective anti-leukemia approaches on acute leukemiaare necessary to improve the current DLI limitations.
Bone Marrow Transplantation* ; Bone Marrow* ; Drug Therapy ; Graft vs Host Disease ; Humans ; Leukemia* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid, Acute ; Leukocytes* ; Lymphocytes ; Pancytopenia ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Recurrence ; Tissue Donors*