Extramedullary relapse of acute myeloid leukemia after the second allogeneic stem cell transplantation, manifested as an intussusception of the intestine
Agata Wrzesień-Kuś, Jacek Treliński, Radzisław Kordek, Jerzy Hołowiecki, Tadeusz Robak
CaseRepClinPractRev 2003; 4(4):308-311
Background: Extramedullary relapses (EMR) after allogeneic stem cell transplantation (alloSCT) occur in up to 20% of patients with acute myelogenous leukemia (AML). However, isolated EMR are rare.
Case report: We present the case of the patient with relapse of acute myeloid leukemia (AML) after 2nd
allogeneic stem cell transplantation (alloSCT), first manifested as an intussusception of an intestine. His peripheral blood and bone marrow examinations at this time were normal. The explorative laparotomy had shown massive infiltration of the small intestine and the root of mesentery with segmental occlusion of the colon due to invagination. Histopathological examination of the biopsy of the intestine revealed the leukemic infiltration. The patient died 3
weeks after the operation as a result of infectious complications and the progression of leukemia.
Conclusion: Timely diagnosis and early re-induction treatment may give a chance for prolonging the life
of some patients in these rare cases of AML with relapse limited to bowel. However the prognosis
of AML relapsed after alloSCT also in the case of isolated EMR is poor and its management is extremely difficult because of cumulative toxicity of the previous intensive treatment.
Keywords: acute myeloid leukemia, Intussusception, allogeneic stem cell transplantation