Acute myeloid leukemia with mediastinal myeloid sarcoma refractory to acute myeloid leukemia therapy but responsive to l-asparaginase
We report the case of a 14-year-old female with acute myeloid leukemia (AML) and myeloid sarcomas (MS) in the anterior mediastinum and around numerous bones. Laboratory tests showed a white blood cell count of 4.0 × 10 9 /l with 7.0 % blasts. Computed tomography revealed a mediastinal mass and pleur...
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| Veröffentlicht in: | International journal of hematology 2012-07, Vol.96 (1), p.136-140 |
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| creator | Takahashi, Hiroyoshi Koh, Katsuyoshi Kato, Motohiro Kishimoto, Hiroshi Oguma, Eiji Hanada, Ryoji |
| description | We report the case of a 14-year-old female with acute myeloid leukemia (AML) and myeloid sarcomas (MS) in the anterior mediastinum and around numerous bones. Laboratory tests showed a white blood cell count of 4.0 × 10
9
/l with 7.0 % blasts. Computed tomography revealed a mediastinal mass and pleural effusion; pleural effusion cytology was negative for malignant cells. In addition, disseminated intravascular coagulation (DIC) was present. Following DIC therapy, thoracoscopic and bone marrow biopsies were performed. Immunostaining and surface marker analysis revealed that the blast cells were positive for cytoplasmic myeloperoxidase, CD4, CD7, CD33, CD44, CD117, and HLA-DR, but negative for CD34 and CD56. Karyotype was normal. MS associated with AML was diagnosed. Multidrug chemotherapy for AML was completely ineffective, and MS continued to progress. Immunohistochemistry revealed that the blasts were negative for asparagine synthetase (AS); therefore, chemotherapy including
l
-asparaginase was initiated. After the first administration of
l
-asparaginase, the patient’s condition improved; however, she subsequently developed tumor lysis syndrome and sepsis, which eventually led to death. Aggressive MS in childhood is rare and refractory to existing AML chemotherapy. Chemotherapy including
l
-asparaginase may prove to be effective in such cases, especially those in which blast cells show negative AS expression. |
| doi_str_mv | 10.1007/s12185-012-1111-0 |
| format | Article |
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9
/l with 7.0 % blasts. Computed tomography revealed a mediastinal mass and pleural effusion; pleural effusion cytology was negative for malignant cells. In addition, disseminated intravascular coagulation (DIC) was present. Following DIC therapy, thoracoscopic and bone marrow biopsies were performed. Immunostaining and surface marker analysis revealed that the blast cells were positive for cytoplasmic myeloperoxidase, CD4, CD7, CD33, CD44, CD117, and HLA-DR, but negative for CD34 and CD56. Karyotype was normal. MS associated with AML was diagnosed. Multidrug chemotherapy for AML was completely ineffective, and MS continued to progress. Immunohistochemistry revealed that the blasts were negative for asparagine synthetase (AS); therefore, chemotherapy including
l
-asparaginase was initiated. After the first administration of
l
-asparaginase, the patient’s condition improved; however, she subsequently developed tumor lysis syndrome and sepsis, which eventually led to death. Aggressive MS in childhood is rare and refractory to existing AML chemotherapy. Chemotherapy including
l
-asparaginase may prove to be effective in such cases, especially those in which blast cells show negative AS expression.</description><identifier>ISSN: 0925-5710</identifier><identifier>EISSN: 1865-3774</identifier><identifier>DOI: 10.1007/s12185-012-1111-0</identifier><identifier>PMID: 22644614</identifier><language>eng</language><publisher>Japan: Springer Japan</publisher><subject>Adolescent ; Antineoplastic Agents - administration & dosage ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Asparaginase - administration & dosage ; Biological and medical sciences ; Case Report ; Fatal Outcome ; Female ; Hematologic and hematopoietic diseases ; Hematology ; Humans ; Leukemia, Myeloid, Acute - complications ; Leukemia, Myeloid, Acute - drug therapy ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Mediastinal Neoplasms - complications ; Mediastinal Neoplasms - diagnosis ; Mediastinal Neoplasms - drug therapy ; Medical sciences ; Medicine ; Medicine & Public Health ; Oncology ; Pneumology ; Sarcoma, Myeloid - drug therapy ; Treatment Outcome ; Tumors of the respiratory system and mediastinum</subject><ispartof>International journal of hematology, 2012-07, Vol.96 (1), p.136-140</ispartof><rights>The Japanese Society of Hematology 2012</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-28a95ebe78e31309578a1837085708109de36b5b8b9f3679365437a31f03f40e3</citedby><cites>FETCH-LOGICAL-c455t-28a95ebe78e31309578a1837085708109de36b5b8b9f3679365437a31f03f40e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12185-012-1111-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12185-012-1111-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26275683$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22644614$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Takahashi, Hiroyoshi</creatorcontrib><creatorcontrib>Koh, Katsuyoshi</creatorcontrib><creatorcontrib>Kato, Motohiro</creatorcontrib><creatorcontrib>Kishimoto, Hiroshi</creatorcontrib><creatorcontrib>Oguma, Eiji</creatorcontrib><creatorcontrib>Hanada, Ryoji</creatorcontrib><title>Acute myeloid leukemia with mediastinal myeloid sarcoma refractory to acute myeloid leukemia therapy but responsive to l-asparaginase</title><title>International journal of hematology</title><addtitle>Int J Hematol</addtitle><addtitle>Int J Hematol</addtitle><description>We report the case of a 14-year-old female with acute myeloid leukemia (AML) and myeloid sarcomas (MS) in the anterior mediastinum and around numerous bones. Laboratory tests showed a white blood cell count of 4.0 × 10
9
/l with 7.0 % blasts. Computed tomography revealed a mediastinal mass and pleural effusion; pleural effusion cytology was negative for malignant cells. In addition, disseminated intravascular coagulation (DIC) was present. Following DIC therapy, thoracoscopic and bone marrow biopsies were performed. Immunostaining and surface marker analysis revealed that the blast cells were positive for cytoplasmic myeloperoxidase, CD4, CD7, CD33, CD44, CD117, and HLA-DR, but negative for CD34 and CD56. Karyotype was normal. MS associated with AML was diagnosed. Multidrug chemotherapy for AML was completely ineffective, and MS continued to progress. Immunohistochemistry revealed that the blasts were negative for asparagine synthetase (AS); therefore, chemotherapy including
l
-asparaginase was initiated. After the first administration of
l
-asparaginase, the patient’s condition improved; however, she subsequently developed tumor lysis syndrome and sepsis, which eventually led to death. Aggressive MS in childhood is rare and refractory to existing AML chemotherapy. Chemotherapy including
l
-asparaginase may prove to be effective in such cases, especially those in which blast cells show negative AS expression.</description><subject>Adolescent</subject><subject>Antineoplastic Agents - administration & dosage</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Asparaginase - administration & dosage</subject><subject>Biological and medical sciences</subject><subject>Case Report</subject><subject>Fatal Outcome</subject><subject>Female</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Hematology</subject><subject>Humans</subject><subject>Leukemia, Myeloid, Acute - complications</subject><subject>Leukemia, Myeloid, Acute - drug therapy</subject><subject>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</subject><subject>Mediastinal Neoplasms - complications</subject><subject>Mediastinal Neoplasms - diagnosis</subject><subject>Mediastinal Neoplasms - drug therapy</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Oncology</subject><subject>Pneumology</subject><subject>Sarcoma, Myeloid - drug therapy</subject><subject>Treatment Outcome</subject><subject>Tumors of the respiratory system and mediastinum</subject><issn>0925-5710</issn><issn>1865-3774</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kc1u1DAUhS0EokPhAdigSKgSG4P_7SyrqlCkSmxgHd1kblqXJA52ApoH6HtzRzMUhMCW5YW_c651DmMvpXgrhfDvilQyWC6k4pIWF4_YRgZnufbePGYbUSvLrZfihD0r5U4I6YXxT9mJUs4YJ82G3Z9364LVuMMhxW014PoVxwjVj7jcViNuI5QlTjA8EAVyl0aoMvYZuiXlXbWkCv7tstxihnlXtetCgjKnqcTvuBcMHMoMGW7IvOBz9qSHoeCL433Kvry__Hxxxa8_ffh4cX7NO2PtwlWA2mKLPqCWWtTWB5BBexEsHSnqLWrX2ja0da-dr7WzRnvQshe6NwL1KXtz8J1z-rZiWZoxlg6HASZMa2mkUKbWtAOhr_9C79KaKQmiTG2cp-QlUfJAdTmVQpk0c44j5B1ZNfuOmkNHDXXU7DtqBGleHZ3XlhJ-UPwqhYCzIwClg4FynrpYfnNOeeuCJk4duEJP0w3mP7743-k_Acrsqbk</recordid><startdate>20120701</startdate><enddate>20120701</enddate><creator>Takahashi, Hiroyoshi</creator><creator>Koh, Katsuyoshi</creator><creator>Kato, Motohiro</creator><creator>Kishimoto, Hiroshi</creator><creator>Oguma, Eiji</creator><creator>Hanada, Ryoji</creator><general>Springer Japan</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7T7</scope><scope>7TM</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20120701</creationdate><title>Acute myeloid leukemia with mediastinal myeloid sarcoma refractory to acute myeloid leukemia therapy but responsive to l-asparaginase</title><author>Takahashi, Hiroyoshi ; Koh, Katsuyoshi ; Kato, Motohiro ; Kishimoto, Hiroshi ; Oguma, Eiji ; Hanada, Ryoji</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-28a95ebe78e31309578a1837085708109de36b5b8b9f3679365437a31f03f40e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Antineoplastic Agents - administration & dosage</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Asparaginase - administration & dosage</topic><topic>Biological and medical sciences</topic><topic>Case Report</topic><topic>Fatal Outcome</topic><topic>Female</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Hematology</topic><topic>Humans</topic><topic>Leukemia, Myeloid, Acute - complications</topic><topic>Leukemia, Myeloid, Acute - drug therapy</topic><topic>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</topic><topic>Mediastinal Neoplasms - complications</topic><topic>Mediastinal Neoplasms - diagnosis</topic><topic>Mediastinal Neoplasms - drug therapy</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Oncology</topic><topic>Pneumology</topic><topic>Sarcoma, Myeloid - drug therapy</topic><topic>Treatment Outcome</topic><topic>Tumors of the respiratory system and mediastinum</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Takahashi, Hiroyoshi</creatorcontrib><creatorcontrib>Koh, Katsuyoshi</creatorcontrib><creatorcontrib>Kato, Motohiro</creatorcontrib><creatorcontrib>Kishimoto, Hiroshi</creatorcontrib><creatorcontrib>Oguma, Eiji</creatorcontrib><creatorcontrib>Hanada, Ryoji</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Nucleic Acids Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of hematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Takahashi, Hiroyoshi</au><au>Koh, Katsuyoshi</au><au>Kato, Motohiro</au><au>Kishimoto, Hiroshi</au><au>Oguma, Eiji</au><au>Hanada, Ryoji</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Acute myeloid leukemia with mediastinal myeloid sarcoma refractory to acute myeloid leukemia therapy but responsive to l-asparaginase</atitle><jtitle>International journal of hematology</jtitle><stitle>Int J Hematol</stitle><addtitle>Int J Hematol</addtitle><date>2012-07-01</date><risdate>2012</risdate><volume>96</volume><issue>1</issue><spage>136</spage><epage>140</epage><pages>136-140</pages><issn>0925-5710</issn><eissn>1865-3774</eissn><abstract>We report the case of a 14-year-old female with acute myeloid leukemia (AML) and myeloid sarcomas (MS) in the anterior mediastinum and around numerous bones. Laboratory tests showed a white blood cell count of 4.0 × 10
9
/l with 7.0 % blasts. Computed tomography revealed a mediastinal mass and pleural effusion; pleural effusion cytology was negative for malignant cells. In addition, disseminated intravascular coagulation (DIC) was present. Following DIC therapy, thoracoscopic and bone marrow biopsies were performed. Immunostaining and surface marker analysis revealed that the blast cells were positive for cytoplasmic myeloperoxidase, CD4, CD7, CD33, CD44, CD117, and HLA-DR, but negative for CD34 and CD56. Karyotype was normal. MS associated with AML was diagnosed. Multidrug chemotherapy for AML was completely ineffective, and MS continued to progress. Immunohistochemistry revealed that the blasts were negative for asparagine synthetase (AS); therefore, chemotherapy including
l
-asparaginase was initiated. After the first administration of
l
-asparaginase, the patient’s condition improved; however, she subsequently developed tumor lysis syndrome and sepsis, which eventually led to death. Aggressive MS in childhood is rare and refractory to existing AML chemotherapy. Chemotherapy including
l
-asparaginase may prove to be effective in such cases, especially those in which blast cells show negative AS expression.</abstract><cop>Japan</cop><pub>Springer Japan</pub><pmid>22644614</pmid><doi>10.1007/s12185-012-1111-0</doi><tpages>5</tpages></addata></record> |
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| identifier | ISSN: 0925-5710 |
| ispartof | International journal of hematology, 2012-07, Vol.96 (1), p.136-140 |
| issn | 0925-5710 1865-3774 |
| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adolescent Antineoplastic Agents - administration & dosage Antineoplastic Combined Chemotherapy Protocols - therapeutic use Asparaginase - administration & dosage Biological and medical sciences Case Report Fatal Outcome Female Hematologic and hematopoietic diseases Hematology Humans Leukemia, Myeloid, Acute - complications Leukemia, Myeloid, Acute - drug therapy Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis Mediastinal Neoplasms - complications Mediastinal Neoplasms - diagnosis Mediastinal Neoplasms - drug therapy Medical sciences Medicine Medicine & Public Health Oncology Pneumology Sarcoma, Myeloid - drug therapy Treatment Outcome Tumors of the respiratory system and mediastinum |
| title | Acute myeloid leukemia with mediastinal myeloid sarcoma refractory to acute myeloid leukemia therapy but responsive to l-asparaginase |
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