Differentiation syndrome during ivosidenib treatment with immunohistochemistry showing isocitrate dehydrogenase R132H mutation

Abstract

We report a case of differentiation syndrome in a patient receiving the IDH1 inhibitor ivosidenib, with skin biopsy showing isocitrate dehydrogenase (IDH) R132Hmutated leukemia cutis. A 72-year-old man with IDH1-mutated acute myeloid leukemia (AML), status-post allogeneic cell transplantation, on ivosidenib for 6 months, was admitted for culture-negative neutropenic fever, pink and purpuric plaques and patches on the legs, abdomen and back, edema, hypotension, and shortness of breath. Skin biopsy revealed an infiltrate of atypical, immature, myeloperoxidase-positive mononuclear cells compatible with leukemia cutis or Sweet syndrome. Although dermal edema and interstitial neutrophilic infiltrate with

Recent advances of IDH1 mutant inhibitor in cancer therapy

“…The patients received oral treatment for 28 consecutive days (100 mg twice daily to 1,200 mg once daily), and the plasma 2-HG levels of all patients decreased significantly to drop to the level range of healthy individuals. For patients with advanced mIDH1 chondrosarcoma, ivosidenib shows low toxicity and relatively ideal treatment results, which is expected to be further promoted in clinical ( Fan et al, 2020b ; Tabata et al, 2020 ).…”