title: Acute myeloid leukemia with t(8;21)(q22;q22) manifesting as granulocytic sarcomas in the rhinopharynx and external acoustic meatus at relapse after high-dose cytarabine: case report and review of the literature.
abstract: We report a 31-year-old female with t(8;21)(q22;q22) acute myeloid leukemia (AML), M2 in the FAB classification. Complete remission was achieved with daunorubicin and cytarabine induction therapy followed by three courses of high-dose cytarabine consolidation. Only 3 months later, the patient relapsed with granulocytic sarcomas (GSs) in her rhinopharynx, external acoustic meatus, and bone marrow. She received focal radiation for the GSs and successfully underwent reinduction chemotherapy. Subsequently, she received a matched related donor peripheral blood stem cell transplantation followed by high-dose chemotherapy and is now in a second remission. We summarized 79 reported cases of t(8;21) AML with GS and reviewed the literature to identify differences in the characteristics of t(8;21) AML with GS between adults and children. To our knowledge, this is the first report of pharyngeal GS in t(8;21) AML, and focal irradiation plus more intensive postinduction therapy during first remission, such as allogeneic-SCT, may be effective in adult t(8;21) AML patients with GS.
authors.affiliation: Second Department of Internal Medicine, Mie University School of Medicine, Tsu, Mie, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Sugimoto
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nishii
authors.forename: Miho
authors.initials: M
authors.lastname: Sakakura
authors.forename: Hiroto
authors.initials: H
authors.lastname: Araki
authors.forename: Eiji
authors.initials: E
authors.lastname: Usui
authors.forename: Felipe
authors.initials: F
authors.lastname: Lorenzo V
authors.forename: Natsuki
authors.initials: N
authors.lastname: Hoshino
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Miyashita
authors.forename: Koshi
authors.initials: K
authors.lastname: Ohishi
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Katayama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shiku
mesh_terms: D000328:Adult; D002891:Chromosomes, Human, Pair 21; D002898:Chromosomes, Human, Pair 8; D003561:Cytarabine / Q000627:therapeutic use; D004423:Ear / Q000473:pathology; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000235:genetics / Q000628:therapy; D009305:Nasopharynx / Q000473:pathology; D036102:Peripheral Blood Stem Cell Transplantation; D011878:Radiotherapy; D012008:Recurrence; D012074:Remission Induction / Q000379:methods; D023981:Sarcoma, Myeloid / Q000175:diagnosis* / Q000628:therapy; D014178:Translocation, Genetic
chemical_list: D003561:Cytarabine