title: Is there a "gold" standard treatment for patients with isolated myeloid sarcoma?
abstract: Isolated myeloid sarcoma is an extramedullary tumor of immature myeloid cells defined by the absence of leukemia history, myelodisplastic syndrome, or myeloproliferative neoplasma with a negative bone marrow biopsy. Myeloid sarcoma is a very rare condition, and few cases have been reported. We reviewed data of 12 patients with isolated myeloid sarcoma managed at a single center to determine the possible prognostic factors affecting patient survival, such as age, sex, type, localization, and treatment options. Patients were mostly men (n=8), with a median age of 39 years. Patients were initially treated with chemotherapy (n=7) or surgery (n=5). In three patients, hematopoietic stem cell transplantation was performed. During the follow-up period, nine patients died. The median overall survival was 13 months, while event-free survival was 8 months. Regarding initial treatment strategy, no significant difference in overall survival was observed. Both chemotherapy and hematopoietic stem cell transplantation independently improved event-free survival. In addition, patients who received chemotherapy combined with hematopoietic stem cell transplantation had significantly longer event-free survival than those treated with chemotherapy alone. Age<40 years together with chemotherapy/hematopoietic stem cell transplantation significant affected event-free survival. Based on our results, the treatment of myeloid sarcoma requires a systemic rather than a localized approach with surgery or radiotherapy. While prospective evaluations are needed, chemotherapy with allogenic hematopoietic stem cell transplantation should be considered as the optimal therapy for isolated myeloid sarcoma.
authors.affiliation: Clinic for hematology, Clinical Center Serbia, Belgrade, Serbia. tweety@scnet.rs
authors.forename: Darko
authors.initials: D
authors.lastname: Antic
authors.forename: Ivo
authors.initials: I
authors.lastname: Elezovic
authors.forename: Natasa
authors.initials: N
authors.lastname: Milic
authors.forename: Nada
authors.initials: N
authors.lastname: Suvajdzic
authors.forename: Ana
authors.initials: A
authors.lastname: Vidovic
authors.forename: Maja
authors.initials: M
authors.lastname: Perunicic
authors.forename: Irena
authors.initials: I
authors.lastname: Djunic
authors.forename: Mirjana
authors.initials: M
authors.lastname: Mitrovic
authors.forename: Dragica
authors.initials: D
authors.lastname: Tomin
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D023981:Sarcoma, Myeloid / Q000473:pathology / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents