Granulocytic sarcoma is a localized tumor composed of immature cells of the granulocytic series. Most granulocytic sarcomas occur in the course of acute leukemia and the blast crisis of chronic leukemia. Rarely, however, it may present before leukemia becomes clinically apparent. It may also occur in patients with myeloproliferative disorders. It has been reported that it occurs in 3% to 9% of patients with acute myelogenous leukemia (AML) and the incidence of granulocytic sarcoma is reported to be higher in patients with t (8;21). However, epidural granulocytic sarcoma associated with t (8;21) is very rare. In this report, we describe a patient with AML associated with t (8;21) in whom the cord compression occurred due to epidural granulocytic sarcoma. In addition, this case present infiltration of both pleura by blast cells. She was treated with local irradiation and chemotherapy successfully.
Blast Crisis ; Drug Therapy ; Humans ; Incidence ; Leukemia ; Leukemia, Myeloid, Acute* ; Myeloproliferative Disorders ; Pleura ; Sarcoma, Myeloid* ; Spine* ; Sternum*

No abstract available.
Humans ; Infant* ; Leukemia, Megakaryoblastic, Acute* ; Sarcoma, Myeloid*

We report a case of acute myelogenous leukemia (AML) developed in a human immunodeficiency virus-infected patient, which is a very rare event. The subtype of AML was initially determined as AML M6a (French-American-British classification), but it was transformed into AML M5b in the course of treatment. Blasts showed very intense staining with periodic acid-Schiff and multiple complex chromosomal abnormalities in the karyotype.
Chromosome Aberrations ; HIV ; Humans ; Karyotype ; Leukemia, Erythroblastic, Acute* ; Leukemia, Myeloid, Acute

To evaluate the sensitivity and specificity analysis of the lineage related antibodies in acute leukemia immunophenotyping by flow cytometry (FCM), immunophenotyping in 184 patients with acute leukemia was performed by FCM analysis. The results showed that in the lineage-related antibodies of acute myelocytic leukemia (AML), the sensitivity of CD13 and CD33 was higher (95.5% and 91.2%, respectively), the specificity of them was deficient (72.5% and 62.2%, respectively); the sensitivity of MPO was low (69.1%), but the specificity was high (100%); the sensitivity and specificity of CD117 were high (88.2% and 100%, respectively); the sensitivity of CD14 and CD15 was low (18.4% and 27.2%, respectively); the specificity of CD14 with monocytes was high. As the lineage-related antibodies of B-lineage ALL were concerned, CD19 showed high sensitivity and low specificity (100% vs 83.4%); the sensitivity and specificity of CD79a (96.4% vs 100%) and CD22 (100% vs 100%) were high; the sensitivity and specificity of CD10 (53.6% vs 82.5%) and CD20 (70.4% vs 87.5%) were low. In T-lineage ALL, the specificity of CD3 was high (97.5%), but the sensitivity was below the mark (80.0%); the sensitivity of CD7 was high (100%), but the specificity was low (77.9%); while the sensitivity and specificity of CD5, CD2 and CD1a were all deficient. In conclusion, the sensitivity and specificity analysis of the lineage-related antibodies in acute leukemia immunophenotyping are coincident with St Jude immunophenotyping project. It seems only that CD117 is superior to MPO in defining AML, but the sensitivity and specificity analysis of CD22 and CD79 are similar in defining B-lineage ALL, therefore, anyone of them may be selected as your need.
Acute Disease ; Adolescent ; Adult ; Aged ; Antibodies, Monoclonal ; immunology ; Antibodies, Neoplasm ; immunology ; CD79 Antigens ; analysis ; immunology ; Child ; Child, Preschool ; Female ; Flow Cytometry ; methods ; Humans ; Immunophenotyping ; methods ; Leukemia ; classification ; immunology ; Leukemia, Erythroblastic, Acute ; immunology ; Leukemia, Monocytic, Acute ; immunology ; Leukemia, Myeloid ; immunology ; Leukemia, Myeloid, Acute ; immunology ; Leukemia, Promyelocytic, Acute ; immunology ; Male ; Middle Aged ; Proto-Oncogene Proteins c-kit ; analysis ; immunology ; Reproducibility of Results ; Sialic Acid Binding Ig-like Lectin 2 ; analysis ; immunology

To compare the clinical outcome of autologous peripheral blood stem cell transplantation (APBSCT) and autologous bone marrow transplantation (ABMT) in treatment of patients with acute leukemia in first remission, 41 patients received APBSCT, 17 patients received unpurged ABMT and 30 patients received purged ABMT. The results showed that hematopoietic recovery was significantly earlier after APBSCT than that after purged or unpurged ABMT. The 3-year disease-free survival (DFS), relapse rate (RR) and transplant-related mortality (TRM) for all patients of 3 groups were 51.7%, 41.7% and 6.8%, respectively. DFS and RR were significantly influenced by disease types (ALL or AML) and intervals between diagnosis and CR(1) or CR(1) and transplant. The main causes of transplant-related death were infection and hemorrhage. After APBSCT, DFS, RR and TRM were 48.4%, 43.9% and 4.9%, respectively, and did not differ significantly from those found in unpurged ABMT (47.1%, 45.6% and 11.8%) or purged ABMT (66.5%, 29.6% and 6.7%). It is concluded that the clinical outcome of APBSCT is similar to unpurged or purged ABMT but APBSCT allows faster recovery of hematopoiesis and needs less transfusion support.
Acute Disease ; Adolescent ; Adult ; Bacterial Infections ; etiology ; mortality ; Bone Marrow Purging ; Bone Marrow Transplantation ; adverse effects ; Child ; Disease-Free Survival ; Female ; Follow-Up Studies ; Hemorrhage ; etiology ; mortality ; Humans ; Leukemia ; pathology ; therapy ; Leukemia, Erythroblastic, Acute ; pathology ; therapy ; Leukemia, Monocytic, Acute ; pathology ; therapy ; Leukemia, Myeloid, Acute ; pathology ; therapy ; Leukemia, Myelomonocytic, Acute ; pathology ; therapy ; Leukemia, Promyelocytic, Acute ; pathology ; therapy ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Peripheral Blood Stem Cell Transplantation ; adverse effects ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; pathology ; therapy ; Remission Induction ; Survival Rate ; Transplantation, Autologous

Leukemia cutis, the specific infiltration of leukemia, can be seen in any leukemia, but, are especially common in the acute myelogenous leukemia M4 and M5 variants. It may clinically mimic many inflammatory dermatoses. We herein report a case of a 59-year-old man with acute monocytic leukemia who concurrently presented with various cutaneous manifestations that clinically resembled benign skin lesions such as rosacea, contact dermatitis, and milium. Histologic study of all the lesions revealed leukemia cutis of the monocytic type. We presented this case to illustrate how leukemia cutis can masquerade as clinically benign-appearing, cutaneous eruptions.
Dermatitis, Contact ; Humans ; Leukemia* ; Leukemia, Monocytic, Acute ; Leukemia, Myeloid, Acute ; Middle Aged ; Rosacea ; Skin ; Skin Diseases

Granulocytic sarcoma is a localized tumor that's composed of immature granulocytic cells and this is more common in patient with 8;21 translocation. We present here a case in a 64-year-old man who was diagnosed with acute myelogenous leukemia (erythroleukemia) that had a complex hyperdiploid karyotype. While he underwent chemotherapy, he developed nausea, vomiting, headache and dysarthria. After several diagnostic work-ups, granulocytic sarcoma in the cerebellum and leptomeningeal metastasis of his leukemia were found on the magnetic resonance imaging and the cerebrospinal fluid cytology.
Brain ; Cerebellum ; Dysarthria ; Headache ; Humans ; Karyotype ; Leukemia ; Leukemia, Erythroblastic, Acute ; Leukemia, Myeloid, Acute ; Magnetic Resonance Imaging ; Middle Aged ; Nausea ; Neoplasm Metastasis ; Sarcoma ; Sarcoma, Myeloid ; Vomiting

Myeloid sarcoma, characterized by the presence of immature myeloid cells occurring at an extramedullary site, is a rare manifestation of acute myelogenous leukemia (AML). Spinal cord compression as an initial presentation of AML is very rare with only a few reported cases. We discuss a case of a 22-year-old male who presented with bicytopenia and paraplegia. Workups were consistent with AML with monocytic differentiation. Chromosomal analysis revealed loss of Y and t (8;21). Spinal cord MRI showed intradural extramedullary-enhancing soft tissue lesions at levels T2 to T7 and L5 to S1, suspected to be myeloid sarcoma. Patient, however, succumbed to severe nosocomial infection prior to initiation of chemotherapy and radiotherapy.
Human ; Leukemia, Monocytic, Acute ; Sarcoma, Myeloid ; Spinal Cord Neoplasms

A localized extramedullary tumor mass composed of immature cells has been reported in association with acute myeloid leukemia, myeloproliferative disorders, myelodysplasia in blast transformation or chronic myeloid leukemia with trilineage hematopoiesis, as well as in patients with no known hematological disorder. Although this tumor may involve anywhere in the body and give rise to a variety of signs and symptoms, there are several case reports of extramedullary tumor in Korea which described the involvement of the gastrointestinal tract. We report the occurrence of gastric extramedullary tumor and lymphoid blast crisis in a patient with complete remission after lymphoblastic transformation of chronic myelogenous leukemia. Endoscopic biopsy for gastric elevated lesion showed diffuse lymphoblast infiltration with TdT (terminal deoxynucleotidal transferase) and CD20 positive immature cells.
Biopsy ; Blast Crisis ; Gastrointestinal Tract ; Hematopoiesis ; Humans ; Korea ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Leukemia, Myeloid, Acute ; Lymphocyte Activation ; Myeloproliferative Disorders ; Sarcoma, Myeloid

BACKGROUND: Acute erythroleukemia (AEL), FAB-M6 is a rare heterogenous disorder diagnosed by myeloblasts more than 30% of nonerythroid cells (NEC). Pure erythroleukemia (Di Guglielmo disease) with an excess of proerythroblasts can be classified as MDS or M0. An aberration of the p53 gene in acute myelogenous leukemia is rare, but related to complex karyotypes with poor prognosis. METHODS: To evaluate heterogenous features, 32 cases of AEL or suspicious AEL were categorized as consisting of more than 50% erythroblasts and M6a with more than 30% myeloblasts of NEC, M6b with more than 30% proerythroblasts of all erythroblasts, and M6c with more than 30% both myeloblasts and proerythroblasts. The relation of the p53 protein overexpression and chromosomal abnormalities to AEL and these subtypes was investigated. RESULTS: There were 18 M6a, 6 M6b, and 8 M6c. The percentage of erythroblasts was M6a 58.7%, 77.7% M6b, and 67.2% M6c. The percentage of myeloblasts in NEC was M6a 53.6%, M6b 4.3%, and M6c 39.2%. The percentage of proerythroblasts in all erythroblasts was M6a 5.6%, M6b 56.2%, and M6c 34.1%. Survivals of M6b and M6c were significantly shorter than M6a (12.0 vs. 2.0 vs. 2.0 months, P=0.003). Five of 11 cases showed complex karyotypes (1 M6a, 2 M6b, 2 M6c), of -5, 5q-, -7, 7q-, -17 and/or 17p-, with shorter survival and poor response. The p53 protein overexpression was M6a 27.3%, M6b 100%, and M6c 83.3%. The p53 protein overexpression was positive in all 5 cases of multiple complex karyotype with frequent treatment failure or shorter survival, but was negative in 5 normal karyotypes. CONCLUSTIONS: The occurrence of complex karyotypes and aberration of the p53 gene frequently observed in M6b and M6c subtypes of acute erythroleukemia would be considered in establishing a new and innovative treatment to target neoplastic proerythroblasts that are resistant to standard therapy for acute myelogenous leukemia.
Chromosome Aberrations ; Erythroblasts ; Genes, p53 ; Granulocyte Precursor Cells ; Karyotype ; Leukemia, Erythroblastic, Acute* ; Leukemia, Myeloid, Acute ; Prognosis ; Treatment Failure