Successful Treatment of Myeloid Sarcoma in an Elderly Patient with Myelodysplastic Syndrome with Reduced-Dose Azacitidine
Myeloid sarcoma (MS), which involves extramedullary lesions, is classified as a unique subtype of acute myeloid leukemia (AML). At present, no standard treatments for MS have been established. The patient was an 89-year-old man with myelodysplastic syndrome-excess blast-2 (MDS-EB-2) with a 2-year hi...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Case Reports in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2021/6640597 |
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| author | Kazuya Sato Nodoka Tsukada Junki Inamura Shigetsuna Komatsu Keisuke Sato Masayo Yamamoto Motohiro Shindo Kentaro Moriichi Yusuke Mizukami Mikihiro Fujiya Yoshihiro Torimoto Toshikatsu Okumura |
| author_facet | Kazuya Sato Nodoka Tsukada Junki Inamura Shigetsuna Komatsu Keisuke Sato Masayo Yamamoto Motohiro Shindo Kentaro Moriichi Yusuke Mizukami Mikihiro Fujiya Yoshihiro Torimoto Toshikatsu Okumura |
| author_sort | Kazuya Sato |
| collection | DOAJ |
| description | Myeloid sarcoma (MS), which involves extramedullary lesions, is classified as a unique subtype of acute myeloid leukemia (AML). At present, no standard treatments for MS have been established. The patient was an 89-year-old man with myelodysplastic syndrome-excess blast-2 (MDS-EB-2) with a 2-year history of intermittent treatment with azacitidine (AZA) during a 4-year history of MDS. He developed painful cutaneous tumors 8 months after the second discontinuation of AZA. They were refractory for antibiotics and topical tacrolimus hydrate. A tumor biopsy was performed, and the histological findings of the tumor lesion showed a proliferation of tumor cells that were positive for myeloperoxidase and CD68 and negative for CD4 and CD123. The patient was diagnosed with MDS-associated MS. MDS-EB-2 quickly progressed to AML with the appearance of peripheral blood blasts and 25% bone marrow blasts. Monotherapy with reduced-dose AZA (37.5 mg/m2 for 7 days, every 4–6 weeks) was restarted, and the MS quickly disappeared. The patient’s MS was successfully treated with 16 cycles of AZA treatment over a 22-month period. There have been 10 reported cases in which MS was successfully treated with AZA. Among the 10 cases, the patient in the present case was the oldest. Treatment with reduced-dose AZA should be considered as a therapeutic option for MS in elderly patients with MDS, especially patients who are ineligible for intensive chemotherapy. |
| format | Article |
| id | doaj-art-12f046c61b4349ceb40c3dc834558abb |
| institution | Kabale University |
| issn | 2090-6560 2090-6579 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hematology |
| spelling | doaj-art-12f046c61b4349ceb40c3dc834558abb2025-02-03T06:43:57ZengWileyCase Reports in Hematology2090-65602090-65792021-01-01202110.1155/2021/66405976640597Successful Treatment of Myeloid Sarcoma in an Elderly Patient with Myelodysplastic Syndrome with Reduced-Dose AzacitidineKazuya Sato0Nodoka Tsukada1Junki Inamura2Shigetsuna Komatsu3Keisuke Sato4Masayo Yamamoto5Motohiro Shindo6Kentaro Moriichi7Yusuke Mizukami8Mikihiro Fujiya9Yoshihiro Torimoto10Toshikatsu Okumura11Department of Hematology/Oncology, Asahikawa Kosei General Hospital, 1-24, Asahikawa 078-8211, JapanDepartment of Hematology/Oncology, Asahikawa Kosei General Hospital, 1-24, Asahikawa 078-8211, JapanDepartment of Hematology/Oncology, Asahikawa Kosei General Hospital, 1-24, Asahikawa 078-8211, JapanDepartment of Dermatology, Asahikawa Kosei General Hospital, 1-24, Asahikawa 078-8211, JapanDepartment of Clinical Laboratory, Asahikawa Kosei General Hospital, 1-24, Asahikawa 078-8211, JapanDivision of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, JapanDivision of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, JapanDivision of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, JapanDivision of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, JapanDivision of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, JapanDivision of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, JapanDivision of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, JapanMyeloid sarcoma (MS), which involves extramedullary lesions, is classified as a unique subtype of acute myeloid leukemia (AML). At present, no standard treatments for MS have been established. The patient was an 89-year-old man with myelodysplastic syndrome-excess blast-2 (MDS-EB-2) with a 2-year history of intermittent treatment with azacitidine (AZA) during a 4-year history of MDS. He developed painful cutaneous tumors 8 months after the second discontinuation of AZA. They were refractory for antibiotics and topical tacrolimus hydrate. A tumor biopsy was performed, and the histological findings of the tumor lesion showed a proliferation of tumor cells that were positive for myeloperoxidase and CD68 and negative for CD4 and CD123. The patient was diagnosed with MDS-associated MS. MDS-EB-2 quickly progressed to AML with the appearance of peripheral blood blasts and 25% bone marrow blasts. Monotherapy with reduced-dose AZA (37.5 mg/m2 for 7 days, every 4–6 weeks) was restarted, and the MS quickly disappeared. The patient’s MS was successfully treated with 16 cycles of AZA treatment over a 22-month period. There have been 10 reported cases in which MS was successfully treated with AZA. Among the 10 cases, the patient in the present case was the oldest. Treatment with reduced-dose AZA should be considered as a therapeutic option for MS in elderly patients with MDS, especially patients who are ineligible for intensive chemotherapy.http://dx.doi.org/10.1155/2021/6640597 |
| spellingShingle | Kazuya Sato Nodoka Tsukada Junki Inamura Shigetsuna Komatsu Keisuke Sato Masayo Yamamoto Motohiro Shindo Kentaro Moriichi Yusuke Mizukami Mikihiro Fujiya Yoshihiro Torimoto Toshikatsu Okumura Successful Treatment of Myeloid Sarcoma in an Elderly Patient with Myelodysplastic Syndrome with Reduced-Dose Azacitidine Case Reports in Hematology |
| title | Successful Treatment of Myeloid Sarcoma in an Elderly Patient with Myelodysplastic Syndrome with Reduced-Dose Azacitidine |
| title_full | Successful Treatment of Myeloid Sarcoma in an Elderly Patient with Myelodysplastic Syndrome with Reduced-Dose Azacitidine |
| title_fullStr | Successful Treatment of Myeloid Sarcoma in an Elderly Patient with Myelodysplastic Syndrome with Reduced-Dose Azacitidine |
| title_full_unstemmed | Successful Treatment of Myeloid Sarcoma in an Elderly Patient with Myelodysplastic Syndrome with Reduced-Dose Azacitidine |
| title_short | Successful Treatment of Myeloid Sarcoma in an Elderly Patient with Myelodysplastic Syndrome with Reduced-Dose Azacitidine |
| title_sort | successful treatment of myeloid sarcoma in an elderly patient with myelodysplastic syndrome with reduced dose azacitidine |
| url | http://dx.doi.org/10.1155/2021/6640597 |
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