Leukemia Cutis in Relapsed Acute Myeloid Leukemia: A Call for Distinct Classification.

Autor: Nahm WJ; New York University Grossman School of Medicine, New York City, NY, USA., Juarez M; The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York City, NY, USA., Abdul-Hay M; Blood and Marrow Transplantation Program, Perlmutter Cancer Center, New York University Langone Health, New York City, NY, USA., Bhatt A; Division of Internal Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA., Meehan SA; The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York City, NY, USA., Shvartsbeyn M; The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York City, NY, USA.
Jazyk: angličtina
Zdroj: The American journal of case reports [Am J Case Rep] 2024 May 18; Vol. 25, pp. e943577. Date of Electronic Publication: 2024 May 18.
DOI: 10.12659/AJCR.943577
Abstrakt: BACKGROUND Acute myeloid leukemia is characterized by dysregulated proliferation and maturation arrest of myeloid precursors, precipitating a spectrum of complications. Among these, leukemia cutis refers specifically to ectopic deposition and proliferation of malignant myeloid cells within the skin. This infiltration pathogenesis remains unclear. Although there are numerous reports of leukemia cutis in the setting of acute myeloid leukemia or primary acute myeloid leukemia, there are no specific reports of leukemia cutis in the setting of relapsed acute myeloid leukemia. CASE REPORT A 59-year-old woman, with a history of remission from poor-risk acute myeloid leukemia, previously treated with chemotherapy and allogenic bone marrow transplant, presented with shortness of breath, lethargy, anemia, thrombocytopenia, and subcutaneous nodules on lower extremities. Leukemia cutis was diagnosed, in the setting of relapsed acute myeloid leukemia. After unsuccessful salvage chemotherapy and being deemed unsuitable for further treatment, she pursued palliative care and died a month later. CONCLUSIONS Our case highlights a lack of reporting or making a distinction of those patients with relapsed acute myeloid leukemia and leukemia cutis. Consequently, it can be deduced that patients who simultaneously have relapsed acute myeloid leukemia and leukemia cutis are expected to fare worse in terms of clinical outcomes than those with primary acute myeloid leukemia and leukemia cutis. Relapsed acute myeloid leukemia patients with leukemia cutis should be classified as a distinct group, warranting further research into aggressive therapeutic targets and survival rates, while emphasizing the need for more vigilant follow-up and lower biopsy thresholds for cutaneous lesions in patients with treated hematologic malignancies.
Databáze: MEDLINE