Extra-medullary relapse of acute myeloid leukemia at phlebotomy and bone marrow sites

Acute myelogenous leukemia can have many sites of extramedullary involvement, including bone, soft tissues, kidneys, lung, gastrointestinal tract, ovary, and skin. Skin involvement usually occurs with no specific favored sites. However, we present a patient who relapsed in phlebotomy sites at both antecubital fossae and at a bone marrow examination site. The combination of repeated trauma and an extramedullary sanctuary (skin) are factors that may warrant disease. Treatment approaches that obviate this problem may be useful in the management of these patients. The clinical and pathological aspects of granulocytic sarcomas are reviewed with an emphasis on skin involvement.

Duke Scholars

Author Gary Herbert Lyman Medicine, Medical Oncology