Bilateral Breast Relapse in Acute Myelogenous Leukemia

Monteleone, Philip; Steele, David A.; King, Alice K.; Konefal, Stanley H.; Kelleher, John F.

doi:10.1097/00043426-200102000-00012

Cited by 6 publications

(4 citation statements)

References 15 publications

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“…Combination local and systemic therapy was given to a total of 34 patients in the three groups, of whom 11 obtained disease control for periods from 2 to 26 years [25, 34–43]. Seven of these responses were in patients with granulocytic sarcomas, where there was a relapse in marrow as late as 8 years [38].…”

Section: Resultsmentioning

confidence: 99%

“…Nineteen relapsed: five first in marrow, 12 in extramedullary sites (eight in breast), and two in both. Five died of transplant‐related causes, one was lost to follow‐up, and six continued disease‐free from 1 to 9 years [39, 43, 47–49, Jakubowski A. Unpublished case.…”

Section: Resultsmentioning

confidence: 99%

“…With these observations, there is little data to justify relying on chemotherapy alone when extramedullary breast tumors, or probably any soft tissue leukemic tumors, are found. The majority of the 46 cases given stem cell transplants after chemotherapy relapsed, but there are seven reports of 2 to 9 year disease‐free survivals in both AML and ALL patients after allogeneic or autologous transplants [15, 39, 43, 47, 49, 70 Jakubowski A. Unpublished case.…”

Section: Discussionmentioning

confidence: 99%

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A basis for updating our approach to resistant acute leukemia

Cunningham

2012

American J Hematol

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No studies exist documenting that chemotherapy alone eradicates tumors composed of leukemic cells in a large group of patients with tumors at any one site. Yet, its use has continued over 40 years in the absence of data. Consensus protocols exist only for testis and meningeal tumors, relying on local therapy. To constitute a body of knowledge about tumors at one site, the breast was chosen and all published cases were analyzed, with follow-up obtained, to document the behavior of acute leukemia tumors and survival after presentation. Among 235 cases (52% published since 2000), overall survival was poor, particularly for the 43% with concurrent morphologic marrow relapse, with 66-73% one-year mortality. Only 4 of 106 patients treated with chemotherapy alone survived 4 years. The majority of AML and ALL tumors were only transiently responsive to anti-leukemia treatments, including transplant, and next relapses were as, or more, common in further tumors than in marrow. A pattern of tumors similar to the metastases of invasive lobular breast cancer was revealed. When relapse occurred in marrow, durable remission was only rarely obtained. These data suggest a potential benefit of incorporating extent of disease workup at diagnosis and relapse into prospective trials. This could yield an accurate incidence of extramedullary tumors and a means to identify occult residual disease which could lead to marrow relapse. This approach could potentially result in greater success in curing acute leukemias. Am. J. Hematol. 87:251-257, 2012. V

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A basis for updating our approach to resistant acute leukemia

Cunningham

2012

American J Hematol

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“…Depending on the clinical situation, the treatment for granulocytic sarcoma may vary from chemotherapy to radiotherapy. Furthermore, aggressive treatment including bone marrow transplantation is recommended [6,15]. Although only few data are available on this unusual disease, accurate diagnosis is required to avoid unnecessary surgery and early aggressive antileukemic therapy.…”

Section: Discussionmentioning

confidence: 99%

Granulocytic Sarcoma in Breast after Bone Marrow Transplantation

et al. 2013

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Granulocytic sarcoma is a localized extramedullary solid tumor composed of immature myeloid cell and is usually associated with acute myeloid leukemia or myelodysplastic syndrome. Although it can involve any site, commonly in lymph nodes, skin, bone and soft tissue, the involvement of breast is unusual. Especially, the involvement of the breast as a pattern of relapse after bone marrow transplantation is extremely rare. We have experienced 2 cases of granulocytic sarcoma after bone marrow transplantation. One case was a 39-year-old woman with right breast mass diagnosed with granulocytic sarcoma. She had received an unrelated bone marrow transplantation due to biphenotype acute leukemia 3 years before our presentation. Another case was a 48-year-old woman with acute myeloid leukemia, who was diagnosed with granulocytic sarcoma on both breasts 8 months after allogenic bone marrow transplantation. We also discuss the clinicopathologic features of granulocytic sarcoma in breast after bone marrow transplantation.

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