title: Multiple extramedullary relapses without bone marrow involvement after second allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia.
abstract: EMR without BM involvement after allogeneic HSCT is extremely rare, especially in children; only a few cases have been reported. A two-yr-old boy was diagnosed with AML (M4) and underwent allogeneic HSCT in first complete remission with BM from HLA-matched unrelated donor without GVHD. Four yr later, he had a BM relapse and after induction and consolidation chemotherapy, he received a second HSCT from an unrelated donor using peripheral blood stem cells. His second post-transplant course was complicated by extensive chronic GVHD involving the skin, oral cavity, and lungs, which was treated with tacrolimus and corticosteroid. Two yr later, he noticed a mild swelling in the right cheek area. The BM showed a complete remission marrow and a soft tissue biopsy was compatible with granulocytic sarcoma. PET-CT showed multifocal bone involvements. He received chemotherapy, and the chloromas decreased in size. We report a case of diffuse EMR of AML without BM involvement after a second allogeneic HSCT.
authors.affiliation: Department of Pediatrics, Hanyang University Medical Center, Seoul, Korea.
authors.forename: Sang Woo
authors.initials: SW
authors.lastname: Yoo
authors.forename: Eun Jin
authors.initials: EJ
authors.lastname: Chung
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Kim
authors.forename: Jeong Hee
authors.initials: JH
authors.lastname: Ko
authors.forename: Hey Sung
authors.initials: HS
authors.lastname: Baek
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Lee
authors.forename: Sung Hee
authors.initials: SH
authors.lastname: Oh
authors.forename: Seok Cheol
authors.initials: SC
authors.lastname: Jeon
authors.forename: Woong Soo
authors.initials: WS
authors.lastname: Lee
authors.forename: Chan Kum
authors.initials: CK
authors.lastname: Park
authors.forename: Chul Hoon
authors.initials: CH
authors.lastname: Lee
mesh_terms: D002675:Child, Preschool; D006086:Graft vs Host Disease; D020544:Graft vs Leukemia Effect; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000276:immunology / Q000473:pathology / Q000601:surgery*; D008297:Male; D012008:Recurrence; D012086:Reoperation; D023981:Sarcoma, Myeloid / Q000175:diagnosis* / Q000276:immunology