Open AccessClinical significance of granulocytic sarcoma in adult patients with acute myeloid leukemia
Author(s) -
Shimizu Hiroaki,
Saitoh Takayuki,
Hatsumi Nahoko,
Takada Satoru,
Yokohama Akihiko,
Handa Hiroshi,
Jimbo Tkahiro,
Sakura Toru,
Tsukamoto Norifumi,
Murakami Hirokazu,
Miyawaki Shuichi,
Nojima Yoshihisa
Publication year - 2012
Publication title -
cancer science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.035
H-Index - 141
eISSN - 1349-7006
pISSN - 1347-9032
DOI - 10.1111/j.1349-7006.2012.02324.x
Subject(s) - medicine , myeloid leukemia , acute promyelocytic leukemia , gastroenterology , leukemia , white blood cell , chemotherapy , multivariate analysis , sarcoma , myeloid , pathology , biology , biochemistry , retinoic acid , gene
To investigate the clinical significance of granulocytic sarcoma ( GS ) in adults with acute myeloid leukemia ( AML ), 434 consecutive patients with AML were analyzed retrospectively. Forty‐five patients (10.4%) with GS at diagnosis were younger ( P < 0.001), presented with higher white blood cell counts ( P = 0.03) and were more likely to conform to F rench– A merican– B ritish M4 ( P = 0.001) and M 5 ( P = 0.045) classifications than those without GS . In contrast, no significant difference in frequency of cytogenetic abnormalities was found between the GS and non‐ GS groups. Treatment outcomes in 260 patients (40 with GS ) who underwent intensive chemotherapy, excluding patients with acute promyelocytic leukemia, were investigated. Complete remission rates did not differ significantly between the GS and non‐ GS groups (75.0% vs 79.1%; P = 0.192, respectively) or the 5‐year overall survival ( OS ) rates (39.9% vs 38.7%; P = 0.749, respectively). However, the GS group had a significantly higher relapse rate than the non‐ GS group (74.2% vs 55.3%; P = 0.048) and a significantly lower 5‐year disease‐free survival rate (8.2% vs 25.7%, respectively; P = 0.005). When considered together with the results of multivariate analysis, which identified the presence of GS as an independent predictor for disease‐free survival time, these findings indicate that GS might identify a high‐risk subset of patients with AML . ( Cancer Sci , doi: 10.1111/j.1349‐7006.2012.02324.x, 2012)