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Case Reports in Hematology
Volume 2017 (2017), Article ID 6350267, 3 pages
Case Report

Extramedullary Relapse in a CML Patient after Allogeneic Stem Cell Transplantation

1Hematology Department, Ataturk Training and Research Hospital, İzmir Katip Celebi University Hospital, İzmir, Turkey
2Hematology Department, Ege University Hospital, İzmir, Turkey
3Pathology Department, Ege University Hospital, İzmir, Turkey
4Hematology Department, Medical Park Hospital, İzmir, Turkey
5Hematology Department, Sivas Numune Hospital, Sivas, Turkey
6Hematology Department, Inonu University Hospital, Malatya, Turkey
7Medical Biology Department, Ege University Hospital, İzmir, Turkey

Correspondence should be addressed to Asu Fergun Yilmaz

Received 30 November 2016; Revised 8 March 2017; Accepted 9 March 2017; Published 21 March 2017

Academic Editor: Kazunori Nakase

Copyright © 2017 Asu Fergun Yilmaz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Myeloid or granulocytic sarcoma (GS) is a tumoral lesion consisting of immature granulocytic cells. It is a rare entity during the course of CML patients especially after allogeneic stem cell transplantation (SCT). Relapse without bone marrow involvement is much rarer. We report a case of CML patient who relapsed with isolated granulocytic sarcoma after allogeneic SCT during cytogenetic and molecular remission. 28-year-old male was diagnosed as CML and allogeneic SCT was performed because of refractory disease to tyrosine kinase inhibitors. Complete cytogenetic and molecular response was achieved after allogeneic SCT followed by dasatinib treatment. Approximately 5 years after the transplantation, very rapidly progressive lesion was documented and diagnosed as GS although he was at molecular and cytogenetic remission. The patient died during chemotherapy due to sepsis. GS relapse after allogeneic SCT is a very rare type of relapse in CML patients with molecular and cytogenetic remission. Since it is a very aggressive disease with a poor prognosis, combined chemoradiotherapies with other possible options like DLI or second allogeneic SCT should be considered as soon as the diagnosis is confirmed.