title: Isolated extramedullary relapse after autologous bone marrow transplantation for acute myeloid leukemia: case report and review of the literature.
abstract: Isolated extramedullary relapse (IEMR) is a pattern of acute myeloid leukemia (AML) relapse post-allogeneic bone marrow transplantation (alloBMT). Less is known about IEMR post-autologous BMT (autoBMT) and about factors associated with IEMR. We report a case of a woman with M4 AML who experienced IEMR post-autoBMT and review the related literature. Seventy-two alloBMT and 3 autoBMT patients, including ours, were identified. The review suggests that an M2 or M4 French-American-British (FAB) phenotype, intermediate cytogenetic risk group, and chromosome 8 abnormalities are more frequently associated with the occurrence of IEMR. IEMR occurs earlier in autoBMT than in alloBMT. Combined treatment with radiation and high-dose chemotherapy may be effective. When we searched the European Bone Marrow Transplant Registry (EBMTR) database, we found the incidence of IEMR to be statistically greater in alloBMT than in autoBMT (11% vs. 6%; P = 0.02), but no correlations have been found with the conditioning transplant regimen used. A closer follow-up, including body and central nervous system scan, should be considered in patients who are undergoing BMT presenting with several IEMR-associated factors.
authors.affiliation: Section of Hematology and Bone Marrow Transplant, Department of Oncology and Hematology, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Potenza
authors.forename: Mario
authors.initials: M
authors.lastname: Luppi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Riva
authors.forename: Monica
authors.initials: M
authors.lastname: Morselli
authors.forename: Angela
authors.initials: A
authors.lastname: Ferrari
authors.forename: Annalisa
authors.initials: A
authors.lastname: Imovilli
authors.forename: Francesca
authors.initials: F
authors.lastname: Giacobbi
authors.forename: Paola
authors.initials: P
authors.lastname: Temperani
authors.forename: Amedea
authors.initials: A
authors.lastname: Donelli
authors.forename: Franco
authors.initials: F
authors.lastname: Narni
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Torelli
mesh_terms: D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D016026:Bone Marrow Transplantation; D002490:Central Nervous System / Q000000981:diagnostic imaging; D002869:Chromosome Aberrations; D002898:Chromosomes, Human, Pair 8; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000008:administration & dosage; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D011859:Radiography; D012008:Recurrence; D012042:Registries; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous
chemical_list: D000964:Antimetabolites, Antineoplastic; D003561:Cytarabine