Clinical Features,early Treatment And Prognostic Analysis Of Myeloid Sarcoma

Objective:1.Clinical data of patients diagnosed with myeloid sarcoma(MS)in our hospital were collected,the significance of immunohistochemistry,gene mutation and chromosome abnormality in the diagnosis of MS was summarized,and survival curve was drawn.2.SEER database was used to explore the impact of early treatment on the survival of patients and to summarize the prognostic factors of MS,in order to improve the understanding of the disease and provide theoretical guidance for the individualized treatment of MS.Methods:1.Clinical data of 12 MS patients admitted to our hospital from January 2015 to June2021 were collected.The clinical manifestations,diagnosis and treatment process and survival status of MS patients were analyzed retrospectively,and the survival curve was drawn.2.Data of 472 MS patients in SEER database were selected,Chi-square test was used to compare clinical features,Kaplan-Meier analysis was used to compare survival differences,and Cox proportional risk model was used to determine prognostic factors affecting overall survival(OS).Results:1.Single center data--clinical characteristics of MS patientsThe ratio of men to women in MS patients was 2:1,and the age range was 24-66 years,with a median age of 42 years.The incidence sites of MS include bone,soft tissue,skin,lymph nodes,gum,throat,testis,pleura,mammary gland,spinal canal and cervix,etc.,among which bone and soft tissue are most easily affected,followed by skin,lymph nodes and central system.The blood routine of MS patients showed no specific manifestations,and MPO,CD117,CD34,CD99,Lys,CD43 and LCA were common immune indexes.The pathological manifestations of MS were atypic cell infiltration,obvious cell atypia,and round,oval or irregular nuclei.In MS patients,ASXL1,JAK2 and TET2 mutations were common,and the proportion of chromosome abnormalities was 50%,showing diversity.2.SEER database--Clinical characteristics,early treatment and prognosis of MS patients2.1 Clinical featuresThe most common sites of MS include bone,lymph nodes,skin and soft tissues.MS is more common in the reproductive and digestive systems than in the skeletal,urinary and nervous systems.The first site of non-isolated myeloid sarcoma(non-IMS)was mostly in the blood system,and 86% of patients were involved in the second site.Isolated myeloid sarcoma(IMS)is more isolated in connective tissue/soft tissue,reproductive system,chest and abdomen,digestive system,lymph nodes and skin,but is mostly confined to a single site.Among 472 MS patients,244 were IMS patients and 228 were non-IMS patients.IMS patients mostly chose local treatment for disease intervention,while non-IMS patients mostly chose chemotherapy,and combination therapy was the secondary intervention for both patients.2.2 Early treatmentIn patients with IMS,there was a significant difference in OS between patients treated with combination therapy and untreated patients(P=0.026),and chemotherapy combined with radiotherapy/surgery should be the preferred treatment.There was no significant difference in OS between treated non-IMS patients and untreated patients(P=0.620),chemotherapy regimens for AML can be selected for early treatment.2.3 Prognostic factorsUnivariate analysis showed that age,first site and first treatment were factors affecting OS in MS patients.Multivariate analysis showed that age and initial site were independent prognostic factors affecting OS in MS patients.In adult patients,those younger than 60 years of age have a better prognosis.The prognosis of patients with digestive system,reproductive system and chest and abdomen was better.Conclusion:1.MS patients are often accompanied by other blood-related diseases,which may involve multiple sites,and clinical diagnosis mainly depends on pathological combined immune typing.2.The results of large sample analysis showed that early combined treatment of IMS patients had longer OS,and chemotherapy combined with radiotherapy/surgery should be the preferred treatment.Early combined treatment of Non-IMS patients did not show obvious advantages,and chemotherapy regimen of AML could be used as an early treatment.3.Age of onset and site of first episode are independent factors affecting the long-term prognosis of MS patients.