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Table 4 Published case reports on radiotherapy for GS

From: Clinicopathologic features and responses to radiotherapy of myeloid sarcoma

Study Patient no. Age Cytogenetics Underlying disease Timing of GS emergence Radiotherapy site Dose fractionation Response
Lee et al.[25] 1 50 t(9;22)(q34;q11) CML Relapse after BMT, BM (-) Clavicle and manubrium 15 Gy CR
Taverna et al.[26] 1 62 - AML-M4 Relapse after chemotherapy, BM also (+) Left gluteal and the deeper pelvic muscles 20 Gy/10fx PR
Au et al.[27] 1 24 del( 5)(q13; q33) AML-M0 Relapse after BMT, BM (-) Left breast 30 Gy PD
Pulsoni et al.[28] 1 84 - De novo sarcoma At presentation, BM (-) Skin 90 Gy/8fx CR
Kasahara et al.[29] 1 47 der (1; 7)(q10; p 10) Idiopathic myelofibrosis and de novo sarcoma At presentation, BM (-) Right submandibular tumor 30 Gy CR
Buckland et al.[30] 1 35 Normal karyotype De novo sarcoma At presentation, BM (-) C4-6 spine 32 Gy/16fx CR
Lee at al.[31] 1 43 - De novo sarcoma At presentation, BM (-) Maxillary gingiva 36 Gy CR
Fleckenstein et al.[32] 1 73 Normal karyotype AML Found at initial presentation with BM (+) Bilateral retrobulbar tumor 30 Gy/15fx CR
Cozzi et al.[33] 1 39 Philadelphia positive CML Chronic phase Left shoulder 21 Gy PD
Nishimura et al.[34] 1 30 Add(3)(q27), t(8;21)(q22,q22) AML-M2 Relapse after BMT, BM (-) Right frontal intra/extracranial tumor 16 Gy CR
Pelosini et al.[35] 1 25 t(8,21)with AML1-ETO expression. AML-M0 Relapse after BMT, BM (-) Left leg 40 Gy CR
Rosenberg et al.[36] 1 8 del(7)(q22;q36),t(7;11)(p15;p15) AML-M2 Relapse after BMT, BM also (+) Bilateral synchronous epibulbar tumor 24 Gy/12fx CR
Pitz et al.[37] 1 50 Normal karyotype AML Relapse after chemotherapy, BM also (+) Uterus/ endometrium 30 Gy/10fx CR
Kumar et al.[38] 1 10 - De novo sarcoma At presentation, BM (-) Left orbit 24 Gy/12fx CR
Vassiliou et al.[39] 1 40 - De novo sarcoma At presentation, BM (-) Mediastinal lymph node 41.4 Gy/23fx CR
Kozelj et al.[40] 1 52 t(8;21) AML At presentation, BM (+) Heart 15 Gy/10fx CR
Lee et al.[41] 1 25 45,X,-Y,del(2)(q21q31),t(5;11)(q31;q13),t(8;21)(q22;q22),t(10;19)(q22;q13.1) De novo sarcoma At presentation, BM (-) Orbit 70 Gy PR
Mauermann et al.[42] 1 70 Normal karyotype De novo sarcoma At presentation, BM (-) Base of the skull to the upper thoracic region, including the brachial plexus 20 Gy/10fx Good PR
Verra et al.[43] 1 45 inv(16) AML-M4 Relapse after BMT, BM (-) L4 to S3 spine 21 Gy/7fx PR
Antic et al.[44] 1 24 Normal karyotype De novo sarcoma At presentation, BM (-) Lumbosacral spine 40 Gy/20fx CR
Mignano et al.[45] 1 20 - AML-M2 Relapse after BMT, BM (-) Left jaw 30 Gy/15fx CR
       Heart 24 Gy/12fx CR
Kim et al.[16] 1 30 - De novo sarcoma At presentation, BM (-) Uterus/cervix 30 Gy CR
Alvarez et al.[46] 1 41 CBFβ/MYH11 fusion and inv(16) (p13q22) AML-M2 At initial presentation, BM also (+) Small bowel, greater omentum and peritoneum 22.4 Gy/14fx CR
Masetti et al.[47] 1 11 11q23 rearrangement (MLL-AF10) AML-M5 In remission after allogeneic hematopoietic stem cell transplantation, BM (-) L1 to S3 Epidural mass 20 Gy/16fx Good PR at the end of RT
Chak et al.[5] 33 (54 courses of radiotherapy) 1.5 - 8 1 - 28 (84.8%) acute non-lymphocytic leukemia, 11 (15.2%) chronic leukiemia - 33% bone, 31% soft tissue, 11% lymph node, 7% spinal cord, 6% brain, 11% other sites (Mediastinal mass, 2; pelvic mass, 1; pleural mass, 1 ; spleen, 1 ; porta hepatis, I)   <1000 rad, CR 18%, 1000–1999 rad, CR 43%; 2000–2900 rad, CR 86%; >3000 rad, CR 89%
Bakst et al.[9] 22 (33 courses of radiotherapy) Median 34 (1–71) - AML 19 (86%), MDS 2 (9%), Isolated Chloroma 1 (5%) 32% in remission (43% of them have GS concomitantly with marrow relapse) 39% head and neck, 24% extremity, 9% spine, 9% brain, 6% genito-urinary, 6% breast, 3% pelvis, and 3% genitourinary Median 20 (6–36) Gy/2 Gy (1.5–4 Gy) CR 97%
  1. Abbreviations: BM = bone marrow; CR = complete response; fx = fraction; Gy = gray; PD = progressive disease; PR = partial response.