Pearson Laurie K, Hamal Ruchi, Yu Sanhong, Miller Kenneth B, Mensah Felix
Division of Hematology/Oncology, Tufts Medical Center, Boston, Massachusetts, USA.
Department of Hematology and Oncology, Mt Auburn Hospital, Cambridge, Massachusetts, USA.
Case Rep Oncol. 2021 Sep 21;14(3):1366-1372. doi: 10.1159/000518529. eCollection 2021 Sep-Dec.
Myeloid sarcoma (MS) is a rare extramedullary manifestation of acute myelogenous leukemia (AML). The mass is composed of primitive myeloid cells that can occur in a variety of organs, most commonly the skin, lymph nodes, GI tract, bone, breast, and CNS. Involvement of the genitourinary tract is rare. Consensus on treatment of MS has not been established, but management typically involves systemic therapy, such as chemotherapy or allogeneic hematopoietic stem cell transplant as well as palliative local therapies such as radiation or surgery. Outcomes of MS using novel AML therapies, such as BCL-2 inhibitors or IDH inhibitors, remain undescribed. We describe a rare case of a 70-year-old man presenting with MS of the urinary bladder complicating known secondary AML (RUNX1 and IDH2 mutated). Prior to development of bladder MS, the patient had received decitabine, enasidenib, and venetoclax. Following diagnosis, he was treated with cytarabine and venetoclax. To our knowledge, this is the first case of bladder MS treated with a BCL-2 inhibitor.
髓系肉瘤（MS）是急性髓系白血病（AML）一种罕见的髓外表现。肿块由原始髓系细胞组成，可发生于多种器官，最常见于皮肤、淋巴结、胃肠道、骨骼、乳腺和中枢神经系统。泌尿生殖道受累罕见。目前尚未就MS的治疗达成共识，但治疗通常包括全身治疗，如化疗或异基因造血干细胞移植，以及姑息性局部治疗，如放疗或手术。使用新型AML疗法（如BCL-2抑制剂或IDH抑制剂）治疗MS的结果尚未见报道。我们描述了一例罕见病例，一名70岁男性，患有膀胱MS，合并已知的继发性AML（RUNX1和IDH2突变）。在膀胱MS发生之前，该患者已接受地西他滨、恩西地平及维奈克拉治疗。诊断后，他接受了阿糖胞苷和维奈克拉治疗。据我们所知，这是首例用BCL-2抑制剂治疗的膀胱MS病例。
