Myeloid Sarcoma: Novel Advances Regarding Molecular Pathogenesis, Presentation and Therapeutic Options

Area of Science:

• Hematology
• Oncology
• Pathology

Background:

• Myeloid sarcoma (MS) is a rare extramedullary tumor composed of myeloid blasts, representing a form of acute myeloid leukemia (AML).
• MS can occur with or without bone marrow involvement, presenting as synchronous or isolated disease.
• Its dissemination to various anatomical sites poses diagnostic and therapeutic complexities.

Purpose of the Study:

• To review recent advances in the diagnosis, molecular background, clinical manifestations, and treatment of myeloid sarcoma.
• To provide a critical analysis of therapeutic decisions for individual MS patients, considering novel targeted AML therapies.
• To discuss central nervous system (CNS) prophylaxis and management strategies for refractory, relapsed, or difficult-to-treat MS cases.

Main Methods:

• Literature review focusing on recent advancements in myeloid sarcoma research.
• Analysis of diagnostic criteria, molecular markers, and clinical presentations across different organ involvements.
• Evaluation of current and emerging treatment modalities, including chemotherapy, radiotherapy, and hematopoietic stem cell transplantation (HSCT).

Main Results:

• Diagnosis of MS remains challenging due to its rarity and diverse clinical presentations.
• Standard treatment often involves AML induction chemotherapy followed by HSCT.
• Targeted AML therapies are influencing MS treatment decisions, alongside considerations for CNS prophylaxis and site-specific management.

Conclusions:

• Optimal management of myeloid sarcoma requires a multidisciplinary approach, integrating recent molecular and clinical findings.
• Hematopoietic stem cell transplantation is a key therapeutic option for many MS patients.
• Further research and prospective trials are needed to refine treatment strategies for this rare AML manifestation.