Good outcome of children with acute myeloid leukemia and t(8;21)(q22;q22), even when associated with granulocytic sarcoma : A report from a single institution in Argentina
✍ Scribed by María S. Felice; Pedro A. Zubizarreta; Elizabeth M. Alfaro; Marta S. Gallego; Ana M. Cygler; Diego A. Rosso; Jorge G. Rossi; Federico Sackmann-Muriel
- Publisher
- John Wiley and Sons
- Year
- 2000
- Tongue
- English
- Weight
- 83 KB
- Volume
- 88
- Category
- Article
- ISSN
- 0008-543X
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✦ Synopsis
BACKGROUND.
The association between t(8;21) and granulocytic sarcoma (GS) is well known, but to the authors' knowledge the prognostic significance of GS in these patients has not been defined clearly.
METHODS.
Between January 1990 and July 1999 174 children with acute myeloid leukemia were admitted to the study institution. Translocation (8;21) was identified in 20 patients (11.5%). Eighteen patients were evaluable for the current study and 8 presented with GS at the time of diagnosis (GSϩ).
RESULTS.
The authors defined two groups of patients: those who were GSϩ and those who were GSϪ. One patient in the GSϩ group and two patients in the GSϪ group died during the induction phase of the study. Complete remission was achieved in seven patients in the GSϩ group and eight patients in the GSϪ group.
Two patients developed a recurrence in the GSϩ group as did one patient in the GSϪ group. The event free-survival probability (the standard error) was 58% (18%) in the GSϩ group and 70% (14%) in the GSϪ group. Localization of GS was in only one site in seven patients and at multiple sites in one patient. Patients with an epidural mass received local radiotherapy (one patient) or surgery (two patients).
Two of these patients developed paraplegia as sequelae: one patient after surgery and one patient after radiotherapy. One patient with orbital GS received local radiotherapy because of progressive proptosis. The remaining four patients had a complete resolution of the GS with chemotherapy only.
CONCLUSIONS.
In the current study of patients with t(8;21)(q22;q22), the presence of granulocytic sarcoma was not found to be an adverse prognostic factor. However, careful attention should be paid, especially to patients with an epidural site, to avoid sequelae. Chemotherapy appears to be the optimum treatment for these children.