Simultaneous Diagnosis of Myeloid Sarcoma of the Jaw and Mycobacterium tuberculosis Infection
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1051
not present any further infectious disease complications
throughout AML chemotherapy treatment [2-9].
In a previous survey, tuberculosis was detected in
2.6% (n = 24 in 129) in all hematological neoplasms in a
10-year period [1]. In this published series no tuber-
culosis wa s diagnosed in AML or MS only MD S (n = 2) .
The univariate analysis of that study identified several
factors associated with a high risk of tuberculosis: chro-
nic lymphocytic leukemia, malnutrition (OR 38.78, 95%
CI 2.35 - 639, p = 0.05), previous corticosteroid use and
use of fludarabine. In the case presented we could only
envision poor dental care but not any of the conditions
associated with a high risk tuberculosis.
According to a study published on Leukemia (2007)
[1], with 92 MSs so far evaluated there were no signi-
ficant differences in survivor incidence between the group
with de novo tumor and the one with concomitant or
those ones with a previous hematological disorder. In-
terestingly, all survivors achieved complete remission
following the first line of therapy. By con trast, only eight
out of sixty patients who deceased obtained complete
remission following the initial therapeutic approach. Six
out of seven survivors underwent allogeneic bone mar-
row transplant, the remaining one having received seve-
ral courses of conventional chemotherapy. Notably, ac-
cording to that study, the patients who died of disease
within the group of transplanted patients (two following
Autologous HSCT used as initial therapy and two who
received allogeneic HSCT as salvage therapy) experi-
enced prolonged survival (from 8 months to six years;
mean 41 months). By contrast, the mean survival of the
patients who underwent chemotherapy, imatinibmesylate,
surgery and radiotherapy were as follows: 7.1 months,
5.6 months, 36 days and 1 week respectively. The sur-
vival rates at 48 months of the patients who did and did
not undergo auto/allogeneic HSCT are 76% vs 0%; p =
0.0000. The clinical behavior and response to therapy
were not influenced by age, sex, anatomic site(s) involv-
ed, clinical presentation, previous clinical history, his-
tology type, phenotype and cytogenetic findings. These
data support the indication of bone marrow transplant as
a consolidation therapy. We concluded this patient had a
synchronous diagnosis of myeloid sarcoma and jaw tu-
berculosis.
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