Isolated Extramedullary Relapse in a Case of Acute Myeloid Leukemia Following Allogeneic Stem Cell Transplantation

Abstract

Background: Acute myeloid leukemia (AML) is the commonest acute leukemia in adults. Allogeneic stem celltransplantation (ASCT) is a curative option for a subset of these patients.Case Presentation: We report the case of a 36 years old female patient who presented in April 2014 with pancytopenia.Investigations revealed that she had AML (M6). She achieved complete remission with induction chemotherapy which wasfollowed by four cycles of consolidation chemotherapy until a human leukocyte antigen-matched donor was available. Sheunderwent ASCT in January 2015. After 14 months, in March 2016, she presented with left breast and rightparapharyngeal masses. Histopathological examination of the excised mass showed infiltration with myeloid cells and thebone marrow was normocellular without leukemic infiltration. She received radiotherapy to the affected breast and thecervical region followed by chemotherapy with good response.Conclusion: AML relapse following ASCT may be in the form of isolated Extramedullary disease. Further research isneeded to optimize the management of these cases.

Keywords

• acute myeloid leukemia
• allogeneic stem cell transplant
• extramedullary relapse