Table 1. Treatment and outcome of 42 CML patients with myeloid sarcoma.
No. | Sex | Age | MS subgroups | Post-MS treatment | Response of MSa | Response of CMLa | F/U timeb (months) | Status at last F/U | Cause of Death | ABL mutations |
---|---|---|---|---|---|---|---|---|---|---|
1 | M | 72.7 | MS1-CP | TKI | PR | SD | 20.5 | Dead | Leukemia PD, MS PD | Noc |
2 | M | 47.8 | MS1-CP | CT+TKI+RT | CR | SD | 26.9 | Dead | Leukemia PD | NT |
3 | M | 50.0 | MS1-CP | CT+TKI Allo-HSCT | CR | MMR | 27.0 | Dead | GvHD | NT |
4 | M | 52.3 | MS1-CP | CT+TKI | CR | CCyR | 36.0 | Dead | Leukemia PD, MS PD | T315Ic |
5 | M | 30.3 | MS1-CP | CT+TKI | NA | NA | 6.2 | Alive | NT | |
6 | F | 63.5 | MS1-CP | TKI | CR | MMR | 14.4 | Alive | NT | |
7 | M | 30.7 | MS1-CP | TKI | CR | CCyR | 14.3 | Alive | NT | |
8 | M | 72.8 | MS1-CP | TKI | CR | MMR | 22.8 | Alive | NT | |
9 | M | 29.2 | MS1-CP | CT+TKI | CR | CMR | 22.8 | Alive | NT | |
10 | M | 52.7 | MS1-CP | CT+TKI | CR | MMR | 27.8 | Alive | NT | |
11 | F | 23.3 | MS1-CP | CT+TKI Allo-HSCT | CR | CMR | 118.8 | Alive | NT | |
12 | M | 52.7 | MS1-CP | CT+TKI Allo-HSCT | CR | CMR | 140.9 | Alive | NT | |
13 | M | 45.3 | MS1-CP | CT+TKI+RT | CR | CMR | 146.6 | Alive | Noc | |
14 | M | 36.3 | MS2-CPd | CT+TKI | PD | PD | 0.8 | Dead | Leukemia PD, MS PD | No |
15 | M | 26.8 | MS2-CP | CT+TKI | PD | PD | 0.9 | Dead | Leukemia PD, MS PD | NT |
16 | M | 75.1 | MS2-CP | TKI | PR | PD | 2.1 | Dead | Leukemia PD | NT |
17 | M | 51.0 | MS2-CPd | CT+TKI+RT | PR | PD | 2.4 | Dead | Leukemia PD | No |
18 | M | 23.2 | MS2-CP | CT+TKI | PR | PD | 4.2 | Dead | Leukemia PD, MS PD | No |
19 | M | 47.8 | MS2-CPd | CT+TKI Allo-HSCT | CR | CCyR | 4.9 | Dead | Leukemia PD | T315I |
20 | M | 23.5 | MS2-CP | CT+TKI | CR | CHR | 6.5 | Dead | Leukemia PD | E255V |
21 | M | 55.5 | MS2-CP | CT+TKI | CR | CCyR | 7.5 | Dead | Leukemia PD, MS PD | NT |
22 | F | 51.7 | MS2-CP | CT | NA | NA | 8.3 | Dead | NA | NT |
23 | M | 51.3 | MS2-CP | CT+TKI | PR | SD | 10.1 | Dead | Leukemia PD, MS PD | NT |
24 | M | 43.1 | MS2-CP | CT+TKI+RT | PR | SD | 13.9 | Dead | Leukemia PD | E255K |
25 | M | 51.4 | MS2-CP | TKI+RT | CR | CCyR | 18.4 | Dead | Leukemia PD, MS PD | NT |
26 | F | 48.4 | MS2-CPd | TKI | CR | MMR | 21.7 | Dead | Leukemia PD, | NT |
27 | M | 57.3 | MS2-CP | CT+TKI Allo-HSCT | CR | CMR | 88.5 | Dead | Esophageal cancer | No |
28 | F | 39.2 | MS2-CP | CT+TKI | CR | CHR | 17.8 | Alive | NT | |
29 | F | 58.4 | MS2-CP | TKI | CR | MMR | 64.4 | Alive | NT | |
30 | M | 56.1 | MS2-CP | TKI | CR | CMR | 126.9 | Alive | NT | |
31 | M | 19.4 | MS2-BP | CT+TKI | PD | PD | 0.8 | Dead | Leukemia PD | E255V/K |
32 | M | 82.7 | MS2-BP | CT+TKI | PD | PD | 2.0 | Dead | Leukemia PD | NT |
33 | M | 45.8 | MS2-BP | CT+TKI | PD | PD | 0.6 | Dead | Leukemia PD, MS PD | No |
34 | F | 31.9 | MS2-BP | CT+TKI+RT Allo-HSCT | PR | CHR | 5.2 | Dead | Leukemia PD | No |
35 | M | 53.4 | MS2-BP | CT+TKI | PD | PD | 7.4 | Dead | Leukemia PD | NT |
36 | M | 53.2 | MS2-BP | CT+TKI | CR | PD | 8.7 | Dead | Leukemia PD | F317L |
37 | M | 54.3 | MS2-BP | CT+TKI Allo-HSCT | CR | CCyR | 9.7 | Dead | Leukemia PD | No |
38 | M | 34.9 | MS2-BP | CT+TKI | CR | MMR | 13.6 | Dead | Infection | E255 |
39 | M | 38.4 | MS2-BP | CT | NA | NA | 15.7 | Alive | NT | |
40 | M | 22.0 | MS2-BP | CT | NA | NA | 0.5 | Alivee | NT | |
41 | F | 59.0 | MS2-BP | CT | NA | NA | 1.0 | Alivee | NT | |
42 | M | 44.3 | MS2-BP | CT+TKI Allo-HSCT | CR | MMR | 28.9 | Alive | NT |
Abbreviations: age, age at diagnosis of MS; allo-HSCT, allogeneic hematopoietic stem cell transplantation; BP, blast phase; CCyR, complete cytogenetic response; CHR, complete hematologic response; CML, chronic myelogenous leukemia; CP, chronic phase; CR, complete response; CT, chemotherapy; F, female; F/U, follow-up; GvHD, graft-vs-host disease; M, male; MMR, major molecular response; MS, myeloid sarcoma; MS1, MS at initial diagnosis of CML; MS2, MS arising during course of treatment; NA, not applicable; NT, not tested; PD, progressive disease; PR, partial remission; RT, radiation treatment; SD, stable disease; TKI, tyrosine kinase inhibitor. CR of MS was defined as complete disappearance of the lesion(s). PR of MS was defined as decreased size but not complete disappearance of the lesion(s). CHR, CCyR and MMR are defined according to the NCCN and European LeukemiaNet Guidelines.
The best initial response of extramedullary and medullary disease after MS emergence.
The follow-up time after MS emergence.
ABL mutations detected after MS emergence.
The patients had a history of CML-BP but reverted to CP status when MS2 developed.
Lost F/U after one course of treatment.