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.
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.
Ando
Toshihiko
T
Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, 755-8505, Japan. ando1013@yamaguchi-u.ac.jp.
Mitani
Noriyuki
N
Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, 755-8505, Japan.
Matsui
Kumiko
K
Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, 755-8505, Japan.
Yamashita
Koji
K
Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, 755-8505, Japan.
Nomiyama
Jun
J
Internal Medicine, Ogoori Daiichi Hospital, Yamaguchi, Japan.
Tsuru
Masatoshi
M
Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, 755-8505, Japan.
Yujiri
Toshiaki
T
Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, 755-8505, Japan.
Tanizawa
Yukio
Y
Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, 755-8505, Japan.
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
D019002:CD56 Antigen