Acute undifferentiated leukemia with undifferentiated myeloid sarcoma: Case report and literature review

• Published in: Medicine (Baltimore) 2024-01, Vol.103 (4), p.e36948
• Main Authors: Luo, Lan, Wang, Xiaoqing, Luo, Ji, Zheng, Shuai, Gong, Ninghan, He, Yuan, Xi, Qian, Chen, Jiao, Jiang, Tao, Zhong, Ling
• Format: Article
• Language: English
• Subjects: Acute Disease; Azacitidine; Bone Marrow - pathology; Humans; Leukemia - diagnosis; Leukemia, Myeloid, Acute - diagnosis; Leukemia, Myeloid, Acute - drug therapy; Leukemia, Myeloid, Acute - pathology; Sarcoma, Myeloid - diagnosis; Sarcoma, Myeloid - drug therapy
• ISSN: 0025-7974; 1536-5964; 1536-5964
• DOI: 10.1097/MD.0000000000036948

With the advancement of diagnostic technology, true acute undifferentiated leukemia (AUL) is becoming more rare, and AUL with extramedullary sarcoma has not been reported. This article reports a case of AUL with extramedullary sarcoma. Flow cytometric analysis of the bone marrow and lymph nodes indicated that the tumor cells of both were of the same origin and mainly expressed stem cell markers and CD7, no myeloid-specific markers, T-lymphoblastic-related markers, and B-lymphoblastic-related markers. Although the priming regimen combined with azacitidine was ineffective, complete remission was achieved by switching to azacitidine combined with HIA (homoharringtonine, idarubicin plus Ara-C). To diagnosis de novo acute leukemia with extensive and comprehensive cellular immune maker detection is available and credible, the expression of a single relatively nonspecific myeloid antigen as a immune maker to detect AUL or AUL associated with sarcoma is precise and effective in our case, which patient was benefit from HIA regiment.