magazinelogo

International Journal of Clinical and Experimental Medicine Research

ISSN Online: 2575-7970 ISSN Print: 2575-7989 CODEN: IJCEMH
Frequency: bimonthly Email: ijcemr@hillpublisher.com
Total View: 2462754 Downloads: 553006 Citations: 244 (From Dimensions)
ArticleOpen Access http://dx.doi.org/10.26855/ijcemr.2023.10.017

Symptoms, Diagnosis, Mechanism, and Treatment of Extramedullary Relapse in Acute Myeloid Leukemia

Xuemin Yang*, Chenli Yue, Ruiqin Wang

Shaanxi Provincial Armed Police Crops Hospital, Xi'an, Shaanxi, China.

*Corresponding author: Xuemin Yang

Published: November 30,2023

Abstract

Acute myeloid leukemia (AML) is a common type of acute leukemia characterized by the abnormal proliferation and accumulation of primitive and naive myeloid cells in the bone marrow and peripheral blood. Chemotherapy and hematopoietic stem cell transplantation (HSCT) are effective treatments for acute myeloid leukemia in hematology. However, some patients still experience relapse after achieving remission, including bone marrow relapse and extramedullary relapse. Extramedullary relapse of acute myeloid leukemia is more common in the central nervous system (CNS), skin, and soft tissue. The pathogenesis of extramedullary relapse is not fully defined and is generally believed to be related to abnormal cytogenetics, leukocytosis at diagnosis, male gender, total body irradiation (TBI), and the condition at the time of transplantation. Currently, the optimal treatment strategy for extramedullary recurrence is controversial. It is generally believed that locally performed combination therapies such as surgery, chemotherapy, and donor lymphocyte infusion are the best choice. Patients with extramedullary recurrence of acute myeloid leukemia have a poor prognosis and shorter median survival.

Keywords

Acute myeloid leukemia, Extramedullary recurrence

References

[1] Mozaheb Z, Khooei A. Bilateral Conjunctival Infiltration as an Extramedullary Relapse of AML [J]. Case Reports in Hematology. 2018: 1-3.

[2] Yuda S, Fuji S, Onishi A, et al. Extramedullary Relapse of Acute Myelogenous Leukemia after Allogeneic Hematopoietic Stem Cell Transplantation [J]. Biology of Blood and Marrow Transplantation. 2019, 25(6): 1152-1157.

[3] Leukemia and Lymphoma Group, Hematology Branch of Chinese Medical Association. Chinese guidelines for the diagnosis and treatment of relapsed and refractory acute myeloid leukemia (2017 edition) [J]. The Chinese Journal of Hematology. 2017, 38(3):183-184.

[4] Yoshihara S, Ikegame K, Kaida K, et al. Incidence of extramedullary relapse after haploidentical SCT for advanced AML/myelodysplastic syndrome [J]. Bone Marrow Transplantation. 2012, 47(5): 669-676.

[5] Clark W B, Strickland S A, Barrett A J, et al. Extramedullary relapses after allogeneic stem cell transplantation for acute myeloid leukemia and myelodysplastic syndrome [J]. Haematologica. 2010, 95(6): 860-863.

[6] Young Kim J, Ah Im S, Hyun Lee J, et al. Extramedullary Relapse of Acute Myeloidand Lymphoid Leukemia in Children: A Retrospective Analysis [J]. Iranian Journal of Pediatrics. 2016, In Press(In Press).

[7] Kiratli H, Demiroğlu H, Emeç S. Ocular relapse in acute myeloid leukemia (M4) with normal bone marrow [J]. International Ophthalmology. 2009, 29(4): 243-245.

[8] Facenda-Lorenzo M, Sánchez-Quintana A, Quijada-Fumero A, et al. Cardiac Relapse of Acute Myeloid Leukemia after Allogeneic Hematopoietic Stem Cell Transplantation [J]. Case Reports in Oncological Medicine. 2016: 1-5.

[9] Kim S J, Kim W G. Sonographic Features of a Myeloid Sarcoma of the Breast as a Relapse of Acute Myeloid Leukemia After Stem-Cell Transplantation: A Case Report [J]. American Journal of Case Reports. 2019, 20: 612-619.

[10] Mazzaglia P J, Strenger R, Castillo J J. Extramedullary relapse of acute myeloid leukemia in a surgical wound [J]. Leukemia & Lymphoma. 2011, 52(3): 541-543.

[11] Imanaka R, Katayama Y, Iwato K, et al. Acute leukemia recurring as extramedullary tumors of the ovary following allogeneic hematopoietic stem cell transplantation [J]. [Rinsho ketsueki] The Japanese journal of clinical hematology. 2018, 59(1): 58.

[12] Kahn R M, Gordhandas S, Chapman-Davis E, et al. Acute Myeloid Leukemia Presenting as Myeloid Sarcoma with a Predisposition to the Gynecologic Tract [J]. Case Reports in Oncological Medicine. 2019: 1-5.

[13] Goh B S, Tang C L, Tan G C. Myeloid Sarcoma of Temporal Bone: A Rare Manifestation of Relapse Acute Myeloid Leukemia[J]. Indian Journal of Otolaryngology and Head & Neck Surgery. 2019, 71(S2): 1023- 1026.

[14] Alhashim N, Aljurf M, Hassanein M, et al. Extramedullary relapses after allogeneic stem cell transplantation for acute myeloid leukemia: clinical characteristics, incidence, risk factors and outcomes [J]. Bone Marrow Transplantation. 2018, 53(7): 838-843.

[15] Stölzel F, Röllig C, Radke J, et al. 18F-FDG-PET/CT for detection of extramedullary acute myeloid leukemia [J]. Haematologica. 2011, 96(10): 1552- 1556.

[16] Rao S, Langston A, Galt J R, et al. Extramedullary Acute Myeloid Leukemia and the Use of FDG-PET/CT [J]. Clinical Nuclear Medicine. 2009, 34(6): 365-366.

[17] de Bonilla Damiá Á, Fernández López R, Acevedo Báñez I, et al. PET/TC con 18F-FDG en la recaída extramedular de una leucemia aguda de linaje ambiguo [J]. Revista Española de Medicina Nuclear e Imagen Molecular. 2019, 38(6): 395-396.

[18] Inoue K, Ogawa H, Yamagami T, et al. Long-term follow-up of minimal residual disease in leukemia patients by monitoring WT1 (Wilms tumor gene) expression levels [J]. Blood. 1996, 88(6): 2267-2278.

[19] Krauter J, Wattjes M P, Nagel S, et al. Real-time RT-PCR for the detection and quantification of AML1/MTG8 fusion transcripts in t(8;21)-positive AML patients [J]. British Journal of Haematology. 1999, 107(1): 80-85.

[20] Ishikawa Y, Kawashima N, Atsuta Y, et al. Prospective evaluation of prognostic impact of KIT mutations on acute myeloid leukemia with RUNX1-RUNX1T1 and CBFB-MYH11[J]. Blood Advances. 2020, 4(1): 66-75.

[21] Lee J W, Kim S, Jang P, et al. Prognostic Role of Postinduction Minimal Residual Disease and Myeloid Sarcoma Type Extrame-dullary Involvement in Pediatric RUNX1-RUNX1T1 (+) Acute Myeloid Leukemia [J]. Journal of Pediatric Hematolo-gy/Oncology. 2020: 1.

[22] Fan Ying. Changes in biological markers after relapse in acute myeloid leukemia [D]. Hebei Medical University. 2012.

[23] Ge L, Ye F, Mao X, et al. Extramedullary Relapse of Acute Leukemia after Allogeneic Hematopoietic Stem Cell Transplantation: Different Characteristics between Acute Myelogenous Leukemia and Acute Lymphoblastic Leukemia [J]. Biology of Blood and Marrow Transplantation. 2014, 20(7): 1040- 1047.

[24] Harris A C, Kitko C L, Couriel D R, et al. Extramedullary relapse of acute myeloid leukemia following allogeneic hematopoietic stem cell transplantation: incidence, risk factors and outcomes [J]. Haematologica. 2013, 98(2): 179- 184.

[25] Chan J K, Tsang W Y, Lau W H, et al. Aggressive T/natural killer cell lymphoma presenting as testicular tumor [J]. Cancer. 1996, 77(6): 1198.

[26] Jiang L, Meng W, Yu G, et al. MicroRNA‑ 144 targets APP to regulate AML1/ETO+ leukemia cell migration via the p‑ERK/c‑Myc/MMP‑2 pathway [J]. Oncology Letters. 2019.

[27] Lee J H, Choi S J, Seol M, et al. Anti-leukemic effect of graft-versus-host disease on bone marrow and extramedullary relapses in acute leukemia [J]. Haematologica. 2005, 90(10):1380.

[28] Schäfer H, Bader P, Kaiserling E, et al. Extramedullary relapses at uncommon sites after allogeneic stem cell transplantation [J]. Bone marrow transplantation. 2000, 26(10):1133- 1134.

[29] Mo X, Kong J, Zhao T, et al. Extramedullary Relapse of Acute Leukemia after Haploidentical Hematopoietic Stem Cell Transplan-tation: Incidence, Risk Factors, Treatment, and Clinical Outcomes [J]. Biology of Blood and Marrow Transplantation. 2014, 20(12): 2023-2028.

[30] Hadid. Leptomeningeal Relapse of Acute Promyelocytic Leukemia [J]. World Journal of Oncology. 2014, 5(2): 77-80.

[31] Gunes G, Goker H, Demiroglu H, et al. Extramedullary relapses of acute leukemias after allogeneic hematopoietic stem cell trans-plantation: clinical features, cumulative incidence, and risk factors [J]. Bone Marrow Transplantation. 2019, 54(4): 595-600.

[32] Sun Yuqian, Huang Xiaojun. Improved strategy for efficacy after allogeneic hematopoietic stem cell transplantation in relapsed leukemia [J]. The Chinese Journal of Hematology. 2017, 38(8):732-736.

[33] Jin M, Hu Y, Wu W, et al. Decitabine plus CLAG chemotherapy as a bridge to haploidentical transplantation in the setting of acute myeloid leukemia relapse after HLA-matched sibling transplantation: a case report [J]. BMC Cancer. 2019, 19(1): 242.

[34] Zhou T, Bloomquist M S, Ferguson L S, et al. Pediatric myeloid sarcoma: a single institution clinicopathologic and molecular analysis [J]. Pediatric Hematology and Oncology. 2020, 37(1): 76-89.

[35] Imanaka R, Katayama Y, Iwato K, et al. Acute leukemia recurring as extramedullary tumors of the ovary following allogeneic hematopoietic stem cell transplantation [J]. [Rinsho ketsueki] The Japanese journal of clinical hematology. 2018, 59(1): 58.

[36] Ochi T, Iwato K, Katayama Y, et al. Post-allogeneic stem cell transplant extramedullary relapse of acute megakaryoblastic leukemia initially detected by elevated WT1 mRNA levels in peripheral blood [J]. Rinsho Ketsueki. 2016, 57(11): 2319-2323.

[37] Schuler E, Boughoufala S, Rautenberg C, et al. Relapse patterns and treatment strategies in patients receiving allogeneic hematopoietic stem cell transplantation for myeloid malignancies [J]. Annals of Hematology. 2019, 98(5): 1225-1235.

How to cite this paper

Symptoms, Diagnosis, Mechanism, and Treatment of Extramedullary Relapse in Acute Myeloid Leukemia

How to cite this paper: Xuemin Yang, Chenli Yue, Ruiqin Wang. (2023) Symptoms, Diagnosis, Mechanism, and Treatment of Extramedullary Relapse in Acute Myeloid Leukemia. International Journal of Clinical and Experimental Medicine Research7(4), 614-618.

DOI: http://dx.doi.org/10.26855/ijcemr.2023.10.017