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Clinicopathological, Cytogenetic, and Prognostic Analysis of 131 Myeloid Sarcoma Patients.

Clinicopathological, Cytogenetic, and Prognostic Analysis of 131 Myeloid Sarcoma Patients.
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Kawamoto K, Miyoshi H, Yoshida N, Takizawa J, Sone H, Ohshima K,


Kawamoto K, Miyoshi H, Yoshida N, Takizawa J, Sone H, Ohshima K, (click to view)

Kawamoto K, Miyoshi H, Yoshida N, Takizawa J, Sone H, Ohshima K,

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The American journal of surgical pathology 2016 9 14()

Abstract

Myeloid sarcoma (MS) is an extramedullary tumor of immature myeloid cells. We analyzed 131 patients with MS, including: (1) de novo MS; (2) MS with concomitant acute myeloid leukemia (AML); (3) MS following myelodysplastic syndrome, myeloproliferative neoplasm, or chronic myelogenous leukemia; and (4) MS as a recurrence of AML. The most common development site was the lymph node. Testicular lesions were statistically more frequent in MS as a recurrence of AML than in other types of MS (P=0.0183). MS tended to lack myeloid markers (myeloperoxidase was present in 63.2%, CD68 in 51.3%, CD13 in 48.7%, and CD33 in 48.7% of patients) and express T-cell markers such as CD3 (20.7%) and CD5 (34.2%). All T-cell marker-positive MS cases were negative for the αβ and γδ T-cell receptors on immunohistochemistry. Underlying myelodysplastic syndrome or myeloproliferative neoplasm was a poor prognostic factor (vs. de novo MS: P=0.0383; vs. MS with concomitant AML: P=0.0143). However, there was no statistical difference in prognosis between de novo MS and MS with concomitant AML (P=0.288). There were no significant differences in prognosis between the prognoses of T-cell marker-positive and T-cell marker-negative MS cases. In addition, CXCR4 expression was a poor prognostic factor in MS (P=0.0229). This study involves the largest MS cohort to date and expands the clinical and pathologic knowledge of the disease.

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