title: Recurrent extramedullary relapse of acute myelogenous leukemia after allogeneic hematopoietic stem cell transplantation in a patient with the chromosomal abnormality t(8;21) and CD56-positivity.
abstract: Isolated extramedullary (EM) relapse of acute myelogenous leukemia (AML) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is rare. Predisposing factors include CD56 expression and the chromosomal abnormality t(8;21). We describe an AML patient showing the chromosomal abnormality t(8;21) and CD56 expression who experienced a unique EM relapse after allo-HSCT. Approximately 10 months after allo-HSCT, he experienced relapse involving the femur and lumbar vertebrae and, subsequently, an EM relapse of the stomach. Although we administered only local radiotherapy and not systemic chemotherapy, he showed no bone marrow relapse on long-term follow-up after achieving complete hematological remission. These findings suggest that the graft-versus-leukemia effect may preferentially maintain marrow remission rather than prevent EM relapse. In addition, our findings show that extended survival is possible after EM relapse following allo-HSCT in patients with marrow hematopoiesis of donor origin, and that augmentation of the graft-versus-leukemia effect may be useful.
authors.affiliation: Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, 755-8505, Japan. ando1013@yamaguchi-u.ac.jp.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ando
authors.affiliation: Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, 755-8505, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Mitani
authors.affiliation: Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, 755-8505, Japan.
authors.forename: Kumiko
authors.initials: K
authors.lastname: Matsui
authors.affiliation: Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, 755-8505, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Yamashita
authors.affiliation: Internal Medicine, Ogoori Daiichi Hospital, Yamaguchi, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Nomiyama
authors.affiliation: Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, 755-8505, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Tsuru
authors.affiliation: Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, 755-8505, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Yujiri
authors.affiliation: Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, 755-8505, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Tanizawa
mesh_terms: D019002:CD56 Antigen / Q000378:metabolism; D002891:Chromosomes, Human, Pair 21; D002898:Chromosomes, Human, Pair 8; D005753:Gastric Mucosa / Q000473:pathology; D020544:Graft vs Leukemia Effect; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000235:genetics / Q000473:pathology / Q000628:therapy; D008297:Male; D012008:Recurrence; D013274:Stomach Neoplasms / Q000235:genetics / Q000473:pathology / Q000628:therapy; D014178:Translocation, Genetic; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D019002:CD56 Antigen