Analysis of the clinical characteristics of granulocytic sarcoma from eleven cases

ZHAO Hui-fang; SONG Yong-ping; ZHOU Jian; WEI Xu-dong; LI Yu-fu; ZHU Xing-hu; ZHANG Yan-li; FANG Bai-jun; FU Yue-wen

Abstract：Objective To enhance the awareness of diagnosis,pathogenesis,therapy,and prognosis of GS.Methods The retrospective analysis was used to analyze 11 cases of GS which were admitted and treated.Resuits 7 patients were misdiagnosed,two of which were misdiagnosed as non-Hodgkin lymphoma,two as prolepses of lumbar intervertebral disc,two as breast neoplasm and one as euroblastoma.The rate of misdiagnesis was 63.6%,with 4 of morphological misdiagnesis (36.4%) and 3 of medical imageology (27.3%).In addition,three patients who relapsed after HSCT had a history of the AML-M2 and had the chromosome abnormality of t(8;21) and one was accompanied by the del (11) (q).8 patients died,with the median survival of 20.5 months (6～40).The median survival of the five patients who accepted conventional chemotherapy was 10 months (6～23).The median survival of three patients who accepted high-dose cytarabine and (or) accepted hematopoietic stem cell transplantation was 35 months (32～40),with a significant advantage to the patients who accepted the conventional chemotherapy.Conclusion GS is tend to be misdiagnosed for its clinical features,medical imageology and morphological characteristics.Combination of bone marrow of morphocytology and karyotype analysis of chromosome may assist diagnosis.Due to the high relapse rate of GS and the poor prognosis,high-intensity chemotherapy might be accounted on to postpone the relapse and improve long-term survival.AML-M2 with the chromosome abnormality of t(8;21) might be a risk factor of GS.