Abstract
Extramedullary manifestations of acute myeloid leukemia (AML) were described as early as the 19th century. However, the incidence, clinical significance and pathobiology of extramedullary AML remain ill defined. We reviewed case reports, retrospective case series, pilot studies and imaging studies of extramedullary leukemia (EML) to determine its frequency, characteristics, clinical presentation and significance. EML precedes or accompanies development of AML and occurs during or following treatment, even during remission. Although imaging studies are rarely conducted and the true incidence of EML has yet to be verified, authors have reported several estimates based on retrospective and autopsy studies. The incidence of EML in patients with AML of all ages is estimated to be about 9% and EML in children with AML was detected in 40% of patients at diagnosis. The combination of positron emission tomography and computed tomography were the most sensitive and reliable techniques of detecting and monitoring EML. Based on our literature review, the frequency of EML is likely underreported. The well-documented nature of EML in patients with AML suggests that AML can manifest as a solid tumor. The extent to which EML accompanies AML and whether EML is derived from bone marrow are unknown. Furthermore, questions remain regarding the role of the microenvironment, which may or may not facilitate the survival and proliferation of EML, and the implications of these interactions with regard to minimal residual disease, tumor cell quiescence and relapse. Therefore, prospective studies of detection and characterization of EML in patients with AML are warranted.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 534-543 |
| Number of pages | 10 |
| Journal | International Journal of Cancer |
| Volume | 133 |
| Issue number | 3 |
| DOIs | |
| State | Published - Aug 1 2013 |
| Externally published | Yes |
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Keywords
- acute myeloid leukemia (AML)
- chronic myeloid leukemia (CML)
- extramedullary leukemia (EML)
- myelodysplastic syndromes (MDS)
- myeloproliferative neoplasms (MPN)
ASJC Scopus subject areas
- Oncology
- Cancer Research
Cite this
Is acute myeloid leukemia a liquid tumor? / Ohanian, Maro; Faderl, Stefan; Ravandi, Farhad; Pemmaraju, Naveen; Garcia-Manero, Guillermo; Cortes, Jorge; Estrov, Zeev.
In: International Journal of Cancer, Vol. 133, No. 3, 01.08.2013, p. 534-543.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Is acute myeloid leukemia a liquid tumor?
AU - Ohanian, Maro
AU - Faderl, Stefan
AU - Ravandi, Farhad
AU - Pemmaraju, Naveen
AU - Garcia-Manero, Guillermo
AU - Cortes, Jorge
AU - Estrov, Zeev
PY - 2013/8/1
Y1 - 2013/8/1
N2 - Extramedullary manifestations of acute myeloid leukemia (AML) were described as early as the 19th century. However, the incidence, clinical significance and pathobiology of extramedullary AML remain ill defined. We reviewed case reports, retrospective case series, pilot studies and imaging studies of extramedullary leukemia (EML) to determine its frequency, characteristics, clinical presentation and significance. EML precedes or accompanies development of AML and occurs during or following treatment, even during remission. Although imaging studies are rarely conducted and the true incidence of EML has yet to be verified, authors have reported several estimates based on retrospective and autopsy studies. The incidence of EML in patients with AML of all ages is estimated to be about 9% and EML in children with AML was detected in 40% of patients at diagnosis. The combination of positron emission tomography and computed tomography were the most sensitive and reliable techniques of detecting and monitoring EML. Based on our literature review, the frequency of EML is likely underreported. The well-documented nature of EML in patients with AML suggests that AML can manifest as a solid tumor. The extent to which EML accompanies AML and whether EML is derived from bone marrow are unknown. Furthermore, questions remain regarding the role of the microenvironment, which may or may not facilitate the survival and proliferation of EML, and the implications of these interactions with regard to minimal residual disease, tumor cell quiescence and relapse. Therefore, prospective studies of detection and characterization of EML in patients with AML are warranted.
AB - Extramedullary manifestations of acute myeloid leukemia (AML) were described as early as the 19th century. However, the incidence, clinical significance and pathobiology of extramedullary AML remain ill defined. We reviewed case reports, retrospective case series, pilot studies and imaging studies of extramedullary leukemia (EML) to determine its frequency, characteristics, clinical presentation and significance. EML precedes or accompanies development of AML and occurs during or following treatment, even during remission. Although imaging studies are rarely conducted and the true incidence of EML has yet to be verified, authors have reported several estimates based on retrospective and autopsy studies. The incidence of EML in patients with AML of all ages is estimated to be about 9% and EML in children with AML was detected in 40% of patients at diagnosis. The combination of positron emission tomography and computed tomography were the most sensitive and reliable techniques of detecting and monitoring EML. Based on our literature review, the frequency of EML is likely underreported. The well-documented nature of EML in patients with AML suggests that AML can manifest as a solid tumor. The extent to which EML accompanies AML and whether EML is derived from bone marrow are unknown. Furthermore, questions remain regarding the role of the microenvironment, which may or may not facilitate the survival and proliferation of EML, and the implications of these interactions with regard to minimal residual disease, tumor cell quiescence and relapse. Therefore, prospective studies of detection and characterization of EML in patients with AML are warranted.
KW - acute myeloid leukemia (AML)
KW - chronic myeloid leukemia (CML)
KW - extramedullary leukemia (EML)
KW - myelodysplastic syndromes (MDS)
KW - myeloproliferative neoplasms (MPN)
UR - http://www.scopus.com/inward/record.url?scp=84878018504&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84878018504&partnerID=8YFLogxK
U2 - 10.1002/ijc.28012
DO - 10.1002/ijc.28012
M3 - Review article
C2 - 23280377
AN - SCOPUS:84878018504
VL - 133
SP - 534
EP - 543
JO - International Journal of Cancer
JF - International Journal of Cancer
SN - 0020-7136
IS - 3
ER -