Good outcome of children with acute myeloid leukemia and t(8;21)(q22;q22),even when associated with granulocytic sarcoma - A report from a single institution in Argentina

BACKGROUND, The association between t(8;21) and granulocytic sarcoma (GS) i s well known, but to the authors' knowledge the prognostic significance of GS in these patients has not been defined clearly. METHODS. Between January 1990 and July 1999 174 children with acute myeloid leukemia were admitted to the study institution. Translocation (8;21) was identified in 20 patients (11.5%). Eighteen patients were evaluable for the current study and 8 presented with GS at the time of diagnosis (GS+). RESULTS. The authors defined two groups of patients: those who were GS+ and those who were GS-. One patient in the GS+ group and two patients in the G S-group died during the induction phase of the study. Complete remission wa s achieved in seven patients in the GS+ group and eight patients in the GS- group. Two patients developed a recurrence in the GS+ group as did one pat ient in the GS- group. The event free-survival probability (the standard er ror) was 58% (18%) in the GS+ group and 70% (14%) in the GS- group. Localiz ation of GS was in only one site in seven patients and at multiple sites in one patient. Patients with an epidural mass received local radiotherapy to ne patient) or surgery (two patients). Two of these patients developed para plegia as sequelae: one patient after surgery and one patient after radioth erapy. One patient with orbital GS received local radiotherapy because of p rogressive proptosis. The remaining four patients had a complete resolution of the GS with chemotherapy only. CONCLUSIONS. In the current study of patients with t(8;21)(q22;q22), the pr esence of granulocytic sarcoma was not found to be an adverse prognostic fa ctor. However, careful attention should be paid, especially to patients wit h an epidural site, to avoid sequelae. Chemotherapy appears to be the optim um treatment for these children. Cancer 2000;88:1939-44. (C) 2000 American Cancer Society.