Children Granulocyte Sarcoma Clinical Characteristics And Preliminary Clinical Observation

Research purpose: Children granulocyte sarcoma have low incidence, so they are easily missed diagnosed and misdiagnosed. This study discusses children granulocyte sarcoma(GS) mode of onset, clinical characteristics, treatment and prognosis, in order to get the guidance for early diagnosis and effective treatment of granulocyte sarcoma. Methods: we analyze 6 cases of children granulocyte sarcoma from department of hematology of Children’s hospital affiliated to Soochow University between June 2009 and June 2014, conclude the mode of onset, clinical manifestation, diagnosis, treatment and outcome. Results: there are 2 cases with a painless mass onset(1 case was 2 years old, characterized by right waist mass, about 10 cm×5 cm, another case was 6 years old, characterized by axillary lump, about 2 cm×3 cm), both of them received surgical removal of the tumor, then examine the postoperative tumor by pathologic and immunohistochemical, at last diagnose primary granulocyte sarcoma; the third case is a 7 years old girl, she was onset characterized by scalp lump, about 2 cm × 3 cm, was diagnosed by the pathologic and immunohistochemical, blood appeared a month later changes in bone marrow examination diagnosed with acute myeloid leukemia;the other 3 cases respectively were in 10 months, 1 year and 7 months, 13 year and 3 months old of onset characterized by scalp lump(about 2 cm ×3 cm), spinal canal tumor(about 1 cm×1.5 cm), intracranial tumors(6 cm× 4.9 cm), with acute myelogenous leukemia(occur at the same time, by surgery pathology, immunohistochemical and bone marrow cell morphology, immune classification, chromosome, fusion gene diagnosis. Which shows four cases of pathology consistent with hematopoietic malignancies, two cases of small round cell tumor;Immune pathology showed five cases of myeloperoxidase(MPO) positive, three cases of CD68 positive, CD43 positive. All children CD56, CD3, CD20, Td T were negative. 4 cases underwent surgery combined with chemotherapy, other 2 cases received surgery and then give up, one case three months later lost, another case died of intracranial hemorrhage after three months, which induced by thrombocytopenia.The treated four cases were followed up 13 to 68 months, and survived with no leukemia. Conclusion: Children granulocyte sarcoma has low incidence and non-specific diagnostic criteria, its diagnosis depends on immune pathology, and the treatment is mainly in accordance with acute myeloid leukemia(AML) program for high-dose chemotherapy. The system chemotherapy helps to prolong overall survival; at the same time, the hematopoietic stem cell transplantation with bone marrow may help to improve the prognosis.