Granulocytic sarcoma causing cord compression in a pregnant woman with acute myeloid leukemia and t(8;21)

Abstract

Chloroma or granulocytic sarcomas (GSs) are solid tumors originating from myeloid precursors. Most frequently they occur in acute myeloid leukemia (AML), myeloproliferative disorder, and myelodysplasia. It may involve any organ system, but mostly it affects the bone and soft tissue of the head and neck. Granulocytic sarcoma resulting in spinal cord compression is rare. The association between t(8;21), and GS has been reported. In spite of the fact that t(8;21) is considered to be associated with good prognosis, patients with GS and spinal cord compression had less favorable prognosis than other AML patients with t(8;21). Radiotherapy, chemotherapy, and surgical decompression are the accepted methods of therapy. However, aggressive therapy such as transplantation may be warranted early in the therapeutic strategy. Pregnancy associated with AML is rare. In our research, only one case of pregnancy with GS and AML has been previously reported. We are reporting a pregnant female diagnosed with AML/M2 with t(8;21) at the first trimester, who relapsed with GS, and cord compression at full term. She had a normal baby, and achieved second remission post-chemotherapy. Unfortunately, shortly after this she had a relapse, and died.