Severe skin rash in two consecutive patients treated with 2-chlorodeoxyadenosine for hairy cell leukaemia at a single institution

Abstract

Although hairy cell leukaemia was first described 40 years ago, it is only in the last decade that newer therapeutic agents have enabled effective treatment. The purine nucleoside analogue, 2-chlorodeoxyadenosine (2-CdA) is currently considered as first-line therapy with a very high rate of complete remission. Although adverse events with 2-CdA are increasingly recognized, severe cutaneous reactions have been reported rarely. We describe two consecutive patients treated with 2-CdA for hairy cell leukaemia who both suffered extremely severe cutaneous reactions, one of which was life-threatening.

Chemotherapeutic agents and the skin: An update

“…The causal relationship between cladribine and these eruptions is therefore questionable. [206][207][208] Capecitabine…”

Vasculitides associated with haematological malignancies: a case-based review

“…Vasculitis maybe the result of a reaction to infection or it may be a paraneoplastic presentation of the leukaemia itself 2 17. Production of cytokines including tumour necrosis factor-α, transforming growth factor-β and various paracrine growth factors by leukaemic cells possibly contributes to the latter.…”

Systemic vasculitis complicating hairy cell leukaemia treatment with cladribine

“…A variety of skin reactions have been reported in patients receiving cladribine, ranging from a maculopapular exanthem to toxic epidermal necrosis, although severe reactions were more often related to antibiotics (Meunier et al, 1996). Grey, Flanagan & Kelsey (2000) reported one case of a generalized erythematous rash with thrombocytopenia a few days after treatment with cladribine, that resolved in 48 h. In another case, they reported an erythematous rash limited initially to the back and inguinal areas, but quickly becoming generalized and vesicular, immediately after 7 days of treatment with cladribine. This was accompanied by modestly impaired renal function and pyrexia.…”