Relapsed acute myeloid leukemia presenting as an isolated central nervous system myeloid sarcoma (CNS MS) is very rare and generally entails poor outcomes. CNS MS treatment is not well defined and can include systemic chemotherapy, intrathecal chemotherapy, radiation therapy, or hematopoietic stem cell transplant. Thiotepa, vinorelbine, topotecan, and clofarabine (TVTC) has been successful for reinduction therapy in relapsed/refractory leukemia to induce remission before hematopoietic stem cell transplant. There is no published evidence of TVTC being utilized for CNS MS. In this series, we report 2 symptomatic patients with isolated CNS MS at relapse who demonstrated near complete resolution after reinduction with TVTC and additional intrathecal chemotherapy.
*Department of Pediatric Hematology-Oncology, Baystate Children’s Hospital, Springfield, MA
†Department of Pediatric Hematology-Oncology, Penn State Milton S. Hershey Medical Center, Hershey, PA
‡Department of Pediatric Hematology-Oncology, University of Louisville, Louisville, KY
Presented previously at the 2018 American Society of Pediatric Hematology/Oncology Annual Meeting in a poster format on May 3, 2018.
The authors declare no conflict of interest.
Reprints: Mustafa Barbour, MD, Department of Pediatrics, Division of Pediatric Hematology and Oncology, University of Louisville, 571 S Floyd St., Suite 445, Louisville, KY 40202 (e-mail: email@example.com).
Received September 21, 2018
Accepted November 13, 2018