Diagnostic and Therapeutic Considerations for Extramedullary Leukemia

Abstract

Purpose of Review

The purpose of this review is to summarize the current literature on the presentation, diagnosis, and treatment options available for extramedullary (EM) manifestations of leukemia including myeloid sarcoma (MS) and leukemia cutis (LC).

Recent Findings

Advanced imaging using 18FDG-PET/CT is an effective screening tool for EM manifestations of leukemia. The role of radiation therapy has been more clearly delineated in the treatment of both MS and LC. FDA-approved targeted agents have improved outcomes in patients with AML but have not demonstrated improvements specifically for EM; however, a checkpoint inhibitor, Ipilimumab, holds promise in impacting local control for the treatment of AML-related EM.

Summary

EM manifestations of leukemia pose significant therapeutic challenges. Treatment of EM is predicated on multiple factors including the presence of concomitant bone marrow involvement, AML-risk classification, and timing of presentation at initial diagnosis or relapse following systemic therapy.

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Bakst, R., Powers, A. & Yahalom, J. Diagnostic and Therapeutic Considerations for Extramedullary Leukemia. Curr Oncol Rep 22, 75 (2020). https://doi.org/10.1007/s11912-020-00919-6

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Keywords

  • Chloroma
  • Myeloid sarcoma
  • Extramedullary leukemia
  • Acute myeloid leukemia