Korean J Hematol.  2010 Mar;45(1):70-72. 10.5045/kjh.2010.45.1.70.

A case of donor-derived granulocytic sarcoma after allogeneic hematopoietic stem cell transplantation

• Jeong SH
• Han JH
• Jeong SY
• Kang SY
• Lee HW
• Choi JH
• Park JS

• KMID: 2252093
• DOI: http://doi.org/10.5045/kjh.2010.45.1.70

Abstract

The occurrence of granulocytic sarcoma as a pattern of relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is rare. In this paper, we report a rare case of acute myeloid leukemia (AML) relapsed as a granulocytic sarcoma of the donor type. The patient was diagnosed as having AML and underwent an allo-HSCT from his matched sibling donor. Fifty-seven months after allo-HSCT, he developed granulocytic sarcomas of duodenum, jejunum, and left sterno-cleido-mastoid muscle. The bone marrow was normal with 100% donor chimerism. A Y chromosome PCR was performed on the patient's duodenum specimen as well as bone marrow aspirate in order to check the patient-origin cells. The duodenal specimen was found to contain 41.2% SRY-positive cells (from the donor). Repeat endoscopy on day 2 of chemotherapy showed that the granulocytic sarcoma had shrunk dramatically. The patient died of sepsis during the nadir state 35 days after starting salvage chemotherapy.

Keyword

Granulocytic sarcoma; AML; Allo-HSCT; Donor type

MeSH Terms

Bone Marrow
Chimerism
Duodenum
Endoscopy
Hematopoietic Stem Cell Transplantation
Hematopoietic Stem Cells
Humans
Jejunum
Leukemia, Myeloid, Acute
Muscles
Polymerase Chain Reaction
Recurrence
Sarcoma, Myeloid
Sepsis
Siblings
Tissue Donors
Y Chromosome

Figure

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  Fig. 1 Endoscopic findings of the duodenal mucosal lesion.

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  Fig. 2 Infiltrating cells were immunoreactive for CD34. Immunohistochemical stain. ×400.

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  Fig. 3 Multiplex short tandem repeat polymerase chain reaction performed for the duodenal biopsy specimen shows that 41.2% of the cells were of donor origin.

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