Myeloid sarcoma with acute promyelocytic leukemia: 2 cases report and literature review / 肿瘤

ABSTRACT

Objective: To describe the diagnosis, treatment and prognosis of acute promyelocytic leukemia (APL) patients with myeloid sarcoma (MS). Methods: The clinical data including the diagnosis and treatment of two patients with APL and MS were reported, and the related literature was reviewed. Results: Case 1 was an APL patient with MS as the initial symptom. The puncture biopsy and immunohistochemistry for a right chest wall mass showed it was in accordance with MS. The system treatment with all-trans retinoic acid (ATRA), arsenic trioxide (ATO) and idarubicin was given to this patient. After one cycle of chemotherapy, the mass on the right chest wall disappeared, and the bone marrow examination showed the complete remission. Then this patient maintained treatment until May 2018. Case 2 was diagnosed as extramedullary recurrence of APL with MS 25-years later. The puncture biopsy and immunohistochemistry for a parasternal mass showed it was in accordance with MS. After one cycle of chemothrapy with ATRA, idarubicin and cytarabine, the parasternal mass remarkably decreased. However, this patient stopped using ATRA after discharging from hospital, then died on 3 April 2017, which were known by phone call following-up. Conclusion: The incidence of APL with MS is low, but the degree of malignancy is high. ATRA and ATO combined chemotherapy is effective, but the overall prognosis is poor.