Leukemia Cutis in an Elderly Patient Treated with Low Dose Cytosine Arabinoside and Etoposide

A 78-year-old man presented with a generalized erythematous papular rash. Such skin lesions were not painful, tender or pruritic, and spread over the truncus. He was admitted to our hospital for examination of the skin lesions. Laboratory tests indicated microcytic hypochromatic anemia and thrombocy...

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Bibliographic Details
Published in:Leukemia & lymphoma 2001, Vol.40 (3-4), p.433-436
Main Authors: Bohgaki, Toshiyuki, Notoya, Atsushi, Kondo, Makoto, Mukai, Masaya, Kohno, Michifumi
Format: Article
Language:English
Subjects:
acute myelomonocytic leukemia
Aged
Antineoplastic Combined Chemotherapy Protocols - administration & dosage
Bone Marrow - pathology
Cytarabine - administration & dosage
Etoposide - administration & dosage
Exanthema - etiology
Humans
Immunophenotyping
Leukemia - diagnosis
Leukemia - drug therapy
leukemia cutis
Leukemia, Myeloid, Acute - diagnosis
Leukemia, Myeloid, Acute - pathology
low dose cytosine arabinoside
Male
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Summary:A 78-year-old man presented with a generalized erythematous papular rash. Such skin lesions were not painful, tender or pruritic, and spread over the truncus. He was admitted to our hospital for examination of the skin lesions. Laboratory tests indicated microcytic hypochromatic anemia and thrombocytopenia, although gave a normal leukocyte count with normal differentiation. His bone marrow showed hypercellularity, with 43% peroxidase positive blasts that displayed positive immunophenotypes for CD4, CD13, CD33, CD41a, KP-1 (CD68), and HLA-DR. His skin specimen revealed infiltration in the dermis and subcutaneous fat tissue by leukemic cells that were positive for the leukocyte common antigen (LCA, CD45), CD15, CD33, CD68, and HLA-DR. He was diagnosed as having M4 subtype of acute myelogeneous leukemia (AML) with leukemia cutis. After three courses of low dose cytosine arabinoside (LDAC), combined with low dose etoposide, he achieved complete remission (CR). He remained well, with no evidence of relapse nine months later. LDAC should be considered as initial treatment for such cases of leukemia cutis with poor general condition.
ISSN:1042-8194
1029-2403
DOI:10.3109/10428190109057945