Myeloid Sarcoma Experience from Tertiary Care Centre of Western India

Objective: In rare cases, haematological malignancies can manifest as an extramedullary malignant myeloid precursor cell mass. Myeloid sarcoma (MS) is a type of leukaemia that can be acute or chronic. At our institute, we will discuss the clinicopathological features and treatment response of patients with myeloid sarcoma (MS).

Methods: From January 2010 to December 2015, we described the clinicopathological features and treatment response of 31 MS patients at the Medical oncology department of Gujarat Cancer Research Institute in Ahemdabad, Gujarat, India, as well as the relevant literature. MS patients were given systemic chemotherapy using AML-like regimens only, or local treatment (radiation, surgery) with or without systemic chemotherapy using AML-like regimens.

Results: This study included 31 patients ranging in age from 6 to 68 years. (median: 32years; mean: 35.8years). There were 15 male and 16 female with a ratio of 0.9:1. The MS occurrence was most common at the lymphnodes (N=7, 22.6%), followed by Bones (N=5, 16.13%) and orbit (N=5, 16.13%) and reproductive organs (N=3, 9.70%). The MS of 5 patients (16.13%) were associated with AML, 5 (16.13%) patients were associated with CML and 21(67.74%) patients had de novo isolated MS. Twelve patients (38.71%) were treated with surgery and/or radiotherapy, chemotherapy (SRC) and nineteen (61.29%) with chemotherapy (C). Sixteen patients (51.61%) achieved a complete remission (CR), ten (32.26%) achieved a partial remission(PR), and five(16.13%) had progression. After treatment, the number of patients who achieved a CR was lower in the C group (N=8, 42.11%) than in the SRC group (N=8, 66.67) (P =0.035). Two patients in the SRC group and four in the C group died during the follow-up period (P =0.72). Survival rates for the SRC and C treatment groups were 83.3 percent and 78.9 percent, respectively (P=0.0328), with both groups lasting 36 months.

Conclusion: To diagnose MS, histopathology, immunohistochemistry, and imaging must be used in tandem. As soon as possible, induction chemotherapy or a tyrosine kinase inhibitor (imatinib) should be administered. Symptomatic lesions or tumours causing organ obstruction are treated with surgery and/or radiotherapy. To describe the characteristics of MS and the role of targeted treatment, prospective controlled trials are required.