Myeloid Sarcoma Transformed From CML Presenting Ectopic Expression of AFP: A Case Report

Background: ： Myeloid Sarcoma (MS) may be transformed from chronic myeloid leukemia (CML). However, no any relationship about MS and significant elevated Alpha-fetoprotein (AFP) as well as multiple osteolytic damage was reported. Case presentation： A 38-years-old man, who was firstly diagnosed as CML chronic phase and treated with imatinib eight years ago, gradually progressed into MS with bone pain and multiple osteolytic damage, especially with elevated AFP. Immunohistochemical staining strongly confirmed that AFP is secreted by MS and its level is fluctuated with treatment outcome. Sequential compound ABL mutations were also identified in bone marrow and finally the patient lost any treatment response to targeted therapy as well as combined chemotherapy. Discussion: and Conclusions： To our knowledge, this case is the first report about MS with aberrant AFP expression.