Isolated Testicular Relapse of Acute Myeloid Leukemia (AML) after Allogeneic Stem Cell Transplantation (ASCT): A Case Report
DOI:
https://doi.org/10.21276/apalm.3524Keywords:
Acute myeloid leukemia, Testis, Cerebrospinal fluid, Relapse, Allogenic Stem Cell TransplanAbstract
Allogenic Stem Cell Transplant (ASCT) is thought to be curative for patients with acute leukemia. Extramedullary relapse after ASCT is a cause for concern, as it usually precedes bone marrow relapse and can result in treatment failure and high mortality rates. The testis is an immune-privileged site, and relapse at this site is rare in AML. Here, we present a case of AML in a patient who had achieved complete remission and undergone ASCT, and who presented with testicular pain a year later. He was diagnosed with testicular relapse and subsequently with involvement of the cerebrospinal fluid (CSF), while his peripheral blood and bone marrow were negative for blasts and free from disease.
References
1. Shem-Tov N, Yerushalmi R, Fein JA, Danylesko I, Shimoni A. Isolated extramedullary relapse of acute leukemia after allogeneic stem cell transplantation: different kinetics and better prognosis than systemic relapse. Biol Blood Marrow Transplant. 2017;23(7):1087–94.
2. Gunes G, Goker H, Demiroglu H, Aksu S, Haznedar R. Extramedullary relapses of acute leukemias after allogeneic hematopoietic stem cell transplantation: clinical features, cumulative incidence, and risk factors. Bone Marrow Transplant. 2019;54(4):595–600.
3. Harris AC, Kitko CL, Couriel DR, Braun TM, Choi SW, Magenau J, et al. Extramedullary relapse of acute myeloid leukemia following allogeneic hematopoietic stem cell transplantation: incidence, risk factors and outcomes. Haematologica. 2013;98(2):179–84.
4. Shafer DW, Burris HA, O'Rourke TJ. Testicular relapse in adult acute myelogenous leukemia. Cancer. 1992;70(6):1541–4.
5. Dang BN, De Oliveira SN, Bowles L, Moore TB. Isolated testicular recurrence of AML in patients with chronic GVHD >1 year following allogeneic stem cell transplant. J Pediatr Hematol Oncol. 2017;39:e423–5.
6. Grier DD, Eskew A, White T, McLean TW. An unusual case of acute myeloid leukemia: late isolated testicular relapse followed by isolated central nervous system relapse. Pediatr Blood Cancer. 2010;55(6):1231–3.
7. Yildirim I, Uçkan D, Cetin M, Tuncer M, Tezcan I. Isolated testicular and bone relapse in children with acute myeloblastic leukemia and chronic graft versus host disease after allogeneic BMT. Turk J Pediatr. 2007;49:206–9.
8. Patto de LS, Figueiredo BC, Campos GAB, Machado RL, Ribeiro RC, Silva SS. Recurrence of acute myeloid leukemia in cryptorchid testis: case report. Einstein (Sao Paulo). 2014;12(1):109–11.
9. Ghadiany M, Attarian H, Hajifathali A, Khosravi A, Molanaee S. Relapse of acute myeloid leukemia as isolated bilateral testicular granulocytic sarcoma in an adult. Urol J. 2008;5(2):132–4.
10. Quaranta BP, Halperin EC, Kurtzberg J, Clough R, Martin PL. The incidence of testicular recurrence in boys with acute leukemia treated with total body and testicular irradiation and stem cell transplantation. Cancer. 2004;101(4):845–50.
11. Amendola BE, Hutchinson R, Grossman HB, Amendola MA. Isolated testicular leukemic relapse response to radiation therapy. Urology. 1987;30(3):240–3.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Bipasha Sinha, Arpita Sutradhar, Debmalya Bhattacharya

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
