International Journal of Hematology

, Volume 108, Issue 4, pp 438–442 | Cite as

Clinical characteristics of pediatric patients with myeloid sarcoma without bone marrow involvement in Japan

  • Takashi Taga
  • Toshihiko Imamura
  • Kentaro Nakashima
  • Naoko Maeda
  • Akihiro Watanabe
  • Yuji Miyajima
  • Sachi Sakaguchi
  • Hitoshi Sano
  • Daiichiro Hasegawa
  • Hirohide Kawasaki
  • Souichi Adachi
  • Masatoshi Takagi
  • Katsuyoshi Koh
  • Atsushi Manabe
  • Tomohiko Taki
  • Yasushi Ishida
Original Article


Myeloid sarcoma (MS) is a rare neoplastic condition that is often described in association with acute myeloid leukemia (AML). MS in childhood has received little attention, particularly in Japan. We carried out a nationwide retrospective analysis of Japanese children diagnosed with MS without bone marrow involvement. Inclusion criteria were diagnosis of MS at younger than 20 years of age between January 1, 2000 and December 31, 2013. There was a predominance of males (8:2), and the median age at MS diagnosis was 4 years. Sites of involvement varied and included skin (n = 3), head and/or neck (n = 2), and multiple sites (n = 2). Karyotypes were evaluated in seven patients, with one individual carrying t(8;21) and t(9;11). Four patients developed bone marrow involvement 2–55 months after diagnosis of MS. All patients received chemotherapy for de novo AML and two individuals received HSCT in first remission. Seven of ten patients survived for 50–152 months (median, 93 months) without disease after initial chemotherapy. This retrospective study confirmed that pediatric MS without bone marrow involvement in Japan is a very rare disease. MS patients responded favorably to therapies for de novo AML, and HSCT in first remission was not indicated for all patients.


Myeloid sarcoma Children AML Chemotherapy 



Complete remission


Stem cell transplantation


AML99 protocol2


CCLSG AML 9805 protocol3


JPLSG AML-05 protocol4


Vincristine, actinomycin D and cyclophosphamide


Etoposide, cytarabine and mitoxantrone


High-dose cytarabine, etoposide and idarubicin


Fludarabine, high-dose cytarabine, granulocyte-colony stimulating factor and idarubicin




Not done


Related bone marrow


Unrelated cord blood


Duration from onset of MS to AML


Overall survival



We deeply thank all members of the JSPHO who cooperated in the retrospective study of rare leukemia of children, including myeloid sarcoma with bone marrow involvement.

Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest in association with this study.


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Copyright information

© The Japanese Society of Hematology 2018

Authors and Affiliations

  • Takashi Taga
    • 1
    • 2
  • Toshihiko Imamura
    • 1
    • 3
  • Kentaro Nakashima
    • 4
  • Naoko Maeda
    • 5
  • Akihiro Watanabe
    • 6
  • Yuji Miyajima
    • 7
  • Sachi Sakaguchi
    • 8
  • Hitoshi Sano
    • 9
  • Daiichiro Hasegawa
    • 10
  • Hirohide Kawasaki
    • 1
    • 11
  • Souichi Adachi
    • 1
    • 12
  • Masatoshi Takagi
    • 1
    • 13
  • Katsuyoshi Koh
    • 1
    • 14
  • Atsushi Manabe
    • 1
    • 15
  • Tomohiko Taki
    • 1
    • 16
  • Yasushi Ishida
    • 1
    • 17
  1. 1.Leukemia/Lymphoma Committee of Japanese Society of Pediatric Hematology and OncologyTokyoJapan
  2. 2.Department of PediatricsShiga University of Medical ScienceOtsuJapan
  3. 3.Department of PediatricsKyoto Prefectural University of MedicineKyotoJapan
  4. 4.Department of Pediatrics, Graduate School of MedicineKyushu UniversityFukuokaJapan
  5. 5.Department of Pediatrics, National Hospital OrganizationNagoya Medical CenterNagoyaJapan
  6. 6.Department of PediatricsNiigata Cancer Center HospitalNiigataJapan
  7. 7.Department of PediatricsAnjo Kosei HospitalAnjoJapan
  8. 8.Department of PediatricsJuntendo University HospitalTokyoJapan
  9. 9.Department of PediatricsTottori University HospitalYonagoJapan
  10. 10.Department of Hematology/OncologyHyogo Children’s Medical CenterKobeJapan
  11. 11.Department of PediatricsKansai Medical UniversityHirakataJapan
  12. 12.Department of Human Health Sciences, Graduate School of MedicineKyoto UniversityKyotoJapan
  13. 13.Department of Pediatrics and Developmental BiologyTokyo Medical and Dental University Graduate School of Medical and Dental SciencesTokyoJapan
  14. 14.Department of Hematology/OncologySaitama Children’s Medical CenterSaitamaJapan
  15. 15.Department of PediatricsSt. Luke’s International HospitalTokyoJapan
  16. 16.Department of Medical TechnologyKyorin University Faculty of Health SciencesMitakaJapan
  17. 17.Department of PediatricsEhime Prefectural Central HospitalMatsuyamaJapan

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