ABSTRACT
Se denomina leucemia cutis a la infiltración cutánea por células leucémicas. Presentamos el caso de una paciente de sexo femenino de 56 años de edad, con diagnóstico reciente de leucemia mieloide aguda, que presenta múltiples lesiones papulosas y tumorales predominantemente en tronco y extremidades, asintomáticas. Los estudios histopatológicos y de inmunohistoquímica confirmaron el diagnóstico de Leucemia Cutis. La paciente recibió tratamiento quimioterápico con remisión de la enfermedad hematológica y desaparición de las lesiones cutáneas, dejando sólo secuelas pigmentarias...
Cutaneous infiltrates of leukemic cells define leukemia cutis. We present a56 year old female patient with a recent diagnosis of acute leukemia, whopresented multiples asymptomatic papules and tumors located on the trunkand extremities. Histological and immunohistochemical studies confirmedthe diagnoses of leukemia cutis. The patient underwent chemotherapy whithremission of both the hematologic and skin manifestations that left pigmentedsequelae...
Subject(s)
Female , Leukemia, Myeloid, Acute , Hemorrhagic Disorders , SkinABSTRACT
Background: Patients with Refractory/Relapsed (RIR) acute leukemia (AL) have a poor prognosis. Objective: We aimed to evaluate the chemotherapy regimen fludarabine, cytarabine, granulocyte colony-stimulating factor, and idarubicin (FLAG-IDA) in patients with RIR AL. Patients: We studied 33 patients with R/R AL. Distribution of the AL subtype was: myeloblastic n=17 (52%), lymphoblastic n=14 (42%),) and biphenotypic n=2 (6%). Results: Complete remission (CR) was achieved in 15 cases (45.5%) and seven patients dead resulting in a mortality of 21.1%. In patients with hematological recovery the median time to neutrophils recovery (> 0.5 x 10º/1) was 24 days (range 10-38); platelet levels of more than 20 x 1Oº/l and 50 x 10º/1 were reached in a median time of 24 (range 17-44) and 27 days (range 18-51), respectively. After CR, five patients underwent allogeneic transplan- tation and 10 patients received a second course of FLAG IDA. Ten out of 15 patients who achieved CR with FLAG-IDA relapsed at a median of 7.7 months (95% CI 1.8 to 13.6 months). Overall survival (OS) after FLAG-IDA in the surviving cohort had a median of 4 months. We found a significantly better OS in patients who received allogeneic transplantation post-FLAG-IDA than those who did not (median 11.4 months vs. 2.7 monthsj HR 0.29; 95% CI 0.1 to 0.6; p=0.017). Conclusions: In our series, FLAG-IDA demonstrated to be an effective salvage chemotherapy regimen, however, the benefit in survival of this rescue treatment was restrained to patients who unde.rwent al1ogeneic transplantation