慢性淋巴细胞白血病患者对2-氯脱氧腺苷的皮肤不良反应组织学上表现为火焰图样改变

来源 :世界核心医学期刊文摘(皮肤病学分册) | 被引量 : 0次 | 上传用户:yangyujie309
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Introduction. 2-Chlorodeoxyadenosine (cladribine or 2-CdA)-is a purine analogue that has been used successfully in hairy cell leukaemia (HCL). Moreover, it has been increasingly used to treat chronic lymphoproliferative syndromes and paediatric acute myeloid leukaemia. Cutaneous side-effects associated with this drug have seldom been described in cases of HCL. Patients and methods. We describe three patients with chronic lymphocytic leukaemia that presented generalized skin eruptions after treatment with 2-CdA. Results. All patients had advanced disease, receiving 2-CdA as a second or third line chemotherapy. Skin lesions were severe and chemotherapy had to be discontinued. Histological examination of skin biopsies showed an eosinophil-rich infiltrate with flame figures, similar to what is observed in Wells’syndrome (eosinophilic cellulitis). Corticosteroids were effective to control the eruptions. Conclusions. Cutaneous adverse reactions associated with 2-CdA have seldom been observed in the treatment of HCL. However, as this purine analogue has been used in more advanced cases these may be more frequent and severe. The pathophysiology of these lesions is unclear, but it is probably related to drug-induced change in T-cell imbalance in severely immunosuppressed patients. Introduction 2-Chlorodeoxyadenosine (cladribine or 2-CdA) -is a purine analogue that has been used successfully in hairy cell leukemia (HCL). Moreover, it has been increasingly used to treat chronic lymphoproliferative syndromes and paediatric acute myeloid leukemia. Cutaneous side Patients and methods. We describe three patients with chronic lymphocytic leukemia that presented generalized skin eruptions after treatment with 2-CdA. Results. All patients had advanced disease, receiving 2- Histological examination of skin biopsies showed an eosinophil-rich infiltrate with flame figures, similar to what is is observed in Wells’ syndrome (eosinophilic cellulitis). Corticosteroids were effective to control the eruptions. Conclusions. Cutaneous adverse reactions associated with 2-CdA have seldom been observed in the treatment of HCL. However, as this purine analogue has been used in more advanced cases these may be more frequent and severe. The pathophysiology of these lesions is unclear, but it may probably related to drug-induced change in T-cell imbalance in severely immunosuppressed patients.
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