Isolated Testicular Recurrence of AML in Patients With Chronic GVHD >1 Year Following Allogeneic Stem Cell Transplant. Issue 8 (November 2017)

• Record Type: Journal Article
• Authors: Dang, Brian N.; De Oliveira, Satiro; Bowles, LaVette; Moore, Theodore B.
• Is Part Of: Journal of pediatric hematology/oncology. Volume 39:Issue 8(2017)
• Publication Date: 2017-11
• Subjects: acute myeloid leukemia -- testicular relapse -- pediatric -- allogeneic stem cell transplant -- chronic graft-versus-host disease; Pediatric hematology -- Periodicals; Tumors in children -- Periodicals; 618.9215
• DOI: 10.1097/MPH.0000000000000989
• Languages: English
• ISSNs: 1077-4114

Abstract

Abstract : Background: Patients with chronic graft-versus-host disease (cGVHD) following allogeneic transplant for myeloid leukemias seem to experience a reduced risk of relapse than comparable patients without cGVHD. It is unclear to what extent extramedullary sites are impacted by a graft-versus-leukemia effect. Design/Method: Case Series and review of the literature. Results: We present 2 cases of pediatric patients with Acute Myelogenous Leukemia who developed isolated testicular relapse more than a year following hematopoietic stem cell transplantation despite having had extensive cGVHD. Both patients were off immunosuppression and cGVHD medications when testicular relapse occurred. At time of relapse, these patients were negative for minimal residual disease in the marrow and the marrow contained all donor cells by engraftment studies. No evidence was found for lymphocyte infiltration into the affected testicle in either patient. Conclusions: Although a reduction of marrow relapse can be appreciated in patients with myeloid leukemias and chronic GVHD, this graft-versus-leukemia process may be less robust in extramedullary sites and careful surveillance should be maintained to allow early intervention before overt marrow involvement.