<p>Skin lesions in chronic myeloid leukemia patients during dasatinib treatment</p>

Abstract

PurposeIn our work we sought to define the prevalence rates of cutaneous events during dasatinib therapy in chronic myeloid leukemia (CML) patients and to investigate the clinical and pathological characteristics of these reactions.Patients and methodsIn our institution, 67 CML patients were treated with dasatinib. it was given as first line treatment in 26 (39%) and subsequent treatment in 41 (61%) CML patients. Flow cytometry analysis of peripheral blood and cutaneous biopsy was done on all CML patients with dermatological lesions appearing during dasatinib treatment.ResultsAmong 67 CML patients, 4 (5.9%) showed skin lesions during dasatinib treatment. The cutaneous manifestations were not generalized but mainly located on the back, abdomen, thorax or leg regions. The patients did not show peripheral lymphocytosis at the time when skin lesions appeared. Overall, histological analysis showed that the skin lesions were characterized by a mild perivascular small CD8+ T lymphocytes infiltrate with minimal epidermotropism.ConclusionThe unusual T cytotoxic cutaneous infiltrate demonstrated in our CML cases could be the expression of a dasatinib-promoted lymphocyte expansion. However, the heterogeneity of the dermatologic manifestations reported in our CML patients could also be related to unknown factors specific to each CML patient. Our work highlights the finding that skin lesions may be associated with dasatinib treatment and that they should not be confused with viral or bacterial infections but rather interpreted as the clinical expression of lymphocytosis promoted by this TKI.

Chronic myeloid leukemia‐leukemia cutis mimicking a neutrophilic panniculitis‐like leukemia cutis: Report of a rare case

“…With treatment of LC, nonleukemic cutaneous manifestations can be seen including purpura, leukocytoclastic vasculitis, neutrophilic dermatoses (such as Sweet syndrome and pyoderma gangrenosum), panniculitis, and infection. Many of these cutaneous manifestations are well‐known adverse reactions to tyrosine kinase inhibitors (TKIs), which are the first‐line treatment in CML as they target the BCR‐ABL1 oncoprotein 3,4,11 …”

“…Many of these cutaneous manifestations are well-known adverse reactions to tyrosine kinase inhibitors (TKIs), which are the first-line treatment in CML as they target the BCR-ABL1 oncoprotein. 3,4,11 The diagnosis of LC is predominantly based on the histopathology and the immunophenotype of the leukemic infiltrate in correlation with the patient's prior history of leukemia if known. Histopathologically, LC typically spares the epidermis and involves the dermis and/or subcutis in a diffuse or nodular pattern and often with perivascular and/or periadnexal involvement.…”

“…LC may be the initial presentation of leukemia or as a secondary presentation in cases of previously diagnosed leukemia. 1,2 While cutaneous adverse events are welldocumented during therapy with tyrosine kinase inhibitors (TKIs) in CML patients, 3,4 it is rare for cutaneous manifestations to be the presenting symptoms for CML. We report an unusual case of leukemia cutis in a patient with CML that presented as a lobular panniculitis.…”

Ferrochelatase: Mapping the Intersection of Iron and Porphyrin Metabolism in the Mitochondria

“…Some protein kinase inhibitors used as cancer chemotherapeutics, such as Alectinib, Cyc-116, Dasatinib, and Vemurafenib, are known to elicit photosensitivity as one of their side effects ( Chapman et al, 2011 ; Peters et al, 2017 ; Tarantini et al, 2019 ). Further characterization of these drugs revealed that most of them bind to and inhibit ferrochelatase ( Klaeger et al, 2016 ).…”

Plaque psoriasis secondary to the use of tyrosine kinase inhibitors, a case report and narrative review of the literature

“…Se han descrito también reacciones como queratosis pilaris o similares, reacciones liquenoides (47,48) , liquen mucoso erosivo (49) , lipoma de células fusiformes, foliculitis en penacho, paniculitis granulomatosa (50) , pseudoporfiria, xerosis cutánea, alopecia, urticaria, eritema multiforme, vasculitis, úlcera cutánea, fibrosis, pustulosis exantemática, dermatosis neutrofílica, paniculitis y síndrome de Stevens-Johnson (51) . En la Tabla 3 se recopilan algunas características histopatológicas reportadas de los efectos adversos cutáneos en pacientes en manejo con ITC.…”