Meis J M, Butler J J, Osborne B M, Manning J T
Cancer. 1986 Dec 15;58(12):2697-709. doi: 10.1002/1097-0142(19861215)58:12<2697::aid-cncr2820581225>3.0.co;2-r.
Sixteen patients presenting with granulocytic sarcoma without evidence of acute leukemia were seen and diagnosed at The University of Texas M.D. Anderson Hospital and Tumor Institute at Houston from 1962 to 1985. Seven of them (44%) did not develop acute leukemia. Of these seven, four are alive with no evidence of disease 3.5 to 16 years after initial presentation; the remaining three patients died of their disease within 2 to 8 months of presentation. Two of 16 patients were diagnosed within the last 15 months and do not have adequate follow-up. The seven remaining patients developed acute leukemia within 1 week to 13 months of the diagnosis of granulocytic sarcoma. Six of them died 5 weeks to 16 months after diagnosis; one patient has been in complete remission for 8 years. Twelve of these 16 cases (75%) were initially misdiagnosed, most frequently as large cell lymphoma. The remaining four cases were correctly diagnosed as granulocytic sarcoma. The naphthol-ASD-chloroacetate esterase stain was required to make the correct diagnosis in all cases. Contrary to findings in other series, granulocytic sarcoma arising in nonleukemic patients does not necessarily progress to acute leukemia. At least four of 16 (25%) patients in this series did not develop acute leukemia during the 3.5 to 16 years they have been followed. No prognostic factors were identified in this series to predict which patients would develop acute leukemia and which ones would not.
1962年至1985年期间，德克萨斯大学MD安德森医院和休斯顿肿瘤研究所共诊治了16例无急性白血病证据的粒细胞肉瘤患者。其中7例（44%）未发生急性白血病。在这7例患者中，4例在初次就诊后3.5至16年存活且无疾病证据；其余3例患者在就诊后2至8个月内死于疾病。16例患者中有2例在过去15个月内被诊断，尚无充分随访。其余7例患者在诊断粒细胞肉瘤后1周内至13个月内发生急性白血病。其中6例在诊断后5周内至16个月内死亡；1例患者已完全缓解8年。这16例病例中有12例（75%）最初被误诊，最常见的误诊为大细胞淋巴瘤。其余4例被正确诊断为粒细胞肉瘤。所有病例均需进行萘酚-ASD-氯乙酸酯酶染色才能做出正确诊断。与其他系列研究结果相反，非白血病患者发生的粒细胞肉瘤不一定会进展为急性白血病。在本系列研究中，至少16例（25%）患者在随访的3.5至16年中未发生急性白血病。本系列研究未发现预测哪些患者会发生急性白血病以及哪些患者不会发生急性白血病的预后因素。
