AML-072 Myeloid Sarcoma Experience from Tertiary Care Centre of Western India

Abstract

In rare cases, hematological malignancies can manifest as an extramedullary malignant myeloid precursor cell mass. Myeloid sarcoma (MS) is a type of leukemia that can be acute or chronic. At our institute, we will discuss the clinicopathological features and treatment responses of patients with MS. From January 2010 to December 2015, we described the clinicopathological features and treatment responses of 31 MS patients at the Medical Oncology Department of Gujarat Cancer Research Institute in Ahmedabad, Gujarat, India, as well as the relevant literature. MS patients were given systemic chemotherapy using acute myeloid leukemia (AML)-like regimens only or local treatment (radiation, surgery) with or without systemic chemotherapy using AML-like regimens. This study included 31 patients ranging in age from 6 to 68 years (median: 32 years; mean: 35.8 years). There were 15 male and 16 female patients with a ratio of 0.9:1. MS occurrence was most common at the lymph nodes (N=7, 22.6%), followed by the bones (N=5, 16.13%), orbit (N=5, 16.13%), and reproductive organs (N=3, 9.70%). MS was associated with AML in 5 patients (16.13%) and chronic myeloid leukemia in 5 patients (16.13%), and 21 patients (67.74%) had de novo isolated MS. Twelve patients (38.71%) were treated with surgery and/or radiotherapy or chemotherapy (SRC) and 19 (61.29%) with chemotherapy (C). Sixteen patients (51.61%) achieved complete remission (CR), 10 (32.26%) achieved partial remission (PR), and 5 (16.13%) had progression. After treatment, the number of patients who achieved CR was lower in the C group (N=8, 42.11%) than in the SRC group (N=8, 66.67%) (P=0.035). Two patients in the SRC group and 4 in the C group died during the follow-up period (P=0.72). Survival rates for the SRC and C treatment groups were 83.3% and 78.9%, respectively (P=0.0328), with both groups lasting 36 months. To diagnose MS, histopathology, immunohistochemistry, and imaging must be used in tandem. As soon as possible, induction chemotherapy or a tyrosine kinase inhibitor (imatinib) should be administered. Symptomatic lesions or tumors causing organ obstruction are treated with surgery and/or radiotherapy. To describe the characteristics of MS and the role of targeted treatment, prospective controlled trials are required.