Clinicopathologic features and responses to radiotherapy of myeloid sarcoma

Radiation Oncology

Ann-Lii Cheng³  Sung-Hsin Kuo³  Hwei-Fang Tien⁶  Jih-Luh Tang⁶  Keng-Hsueh Lan⁴  Heng-Hsiu Liu⁵  Chin-Hao Chang¹  Chun-Wei Wang⁴  Wan-Yu Chen² 

[1] Department of Medical Research, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan;Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan;Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan;Cancer Research Center, National Taiwan University College of Medicine, Taipei, Taiwan;National Translational Medicine and Clinical Trial Resource Center, Taipei, Taiwan;Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

关键词: Radiotherapy;    Extramedullary leukemia;    Myeloid sarcoma;    Granulocytic sarcoma;    Chloroma;   

Others  :  1152667
DOI  :  10.1186/1748-717X-8-245

 received in 2013-03-26, accepted in 2013-10-15,  发布年份 2013

【 摘 要 】

Background

To evaluate clinicopathological features, radiotherapeutic parameters, and their associations with responses to radiotherapy (RT) in patients with myeloid sarcoma (MS).

Methods

We reviewed 20 patients receiving RT for MS lesions (in 43 RT courses) and analyzed the patients’ clinicopathologic features and radiotherapeutic parameters, and their associations with complete responses (CR) to RT using Fisher’s exact test and univariate logistic regression analysis. Generalized Estimating Equation was used to analyze all 43 irradiated lesions and account for the correlations in RT responses among lesions from the same patient.

Results

We found that the underlying hematological diseases of the evaluated patients were acute myeloid leukemia (AML) in 14 patients (70%), chronic myeloid leukemia in 4 patients (20%), myelodysplastic syndrome with AML transformation in one patient (5%), and de novo MS in one patient (5%). Most patients (55%) received RT for MS at the time of relapse following bone marrow transplantation (BMT). The most common cytogenetic abnormality was t(8;21)(q22;q22). The median RT dose of 20 Gy (range 6–35 Gy), administered in 1.5-3.5 Gy fractions, provided a 63% CR rate. RT dose, sex, cytogenetics, and bone marrow status at the time of RT had no significant effect on CR. Younger age (<50 y, P = 0.06), BMT prior to RT (P = 0.05), and underlying AML (P = 0.05) were marginally associated with higher CR to RT.

Conclusions

Our results indicate that a modest RT dose (20-30 Gy) achieves good local control of MS. Age, previous BMT, and underlying hematologic disease can affect RT response.

【 授权许可】

   
2013 Chen et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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