Myeloid sarcomas: Experience from a pediatric oncology referral center

OBJECTIVE: To analyze the experience in the management of myeloid sarcomas at a pediatric oncology referral center. MATERIAL AND METHODS: A descriptive, retrospective study of patients under 18 years of age diagnosed with myeloid sarcoma between 2010 and 2024. Demographic variables, underlying disease, tumor location, tumor size, treatment, and clinical outcome were collected. The analysis was performed using IBM® SPSS Statistics 30.0. RESULTS: Seventeen myeloid sarcomas were identified in 14 patients, 13 (76.5%) of whom were male. The median age at diagnosis was 4.33 years (range: 1 month-14.5 years). In 10 cases (58.8%), the sarcoma was the first manifestation of an underlying hematologic malignancy. Biopsy was performed in 12 cases (70.6%). The most frequent locations were soft tissues (47.1%) and bone (23.5%). The mean tumor volume was 45.2 cm3. Acute myeloid leukemia was the most common underlying neoplasm (n= 14), followed by B-cell acute lymphoblastic leukemia (n= 3). Eight myeloid sarcomas (47.1%) resolved after a first cycle of chemotherapy, 6 (35.3%) required additional cycles, 2 (11.8%) received local treatment, and in 1 case (5.9%) resolution was not achieved. CONCLUSIONS: Myeloid sarcoma represents an uncommon extramedullary manifestation. Early diagnosis, based on a high index of suspicion and appropriate clinical and radiological characterization, is crucial to establish an effective therapeutic approach and improve prognosis.