Enhanced skin toxicity associated with the combination of clofarabine plus cytarabine for the treatment of acute leukemia

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• 作者：Bingnan Zhang (1)
  Jean Bolognia (2)
  Peter Marks (3)
  Nikolai Podoltsev (3)
  
• 关键词：Toxic erythema of chemotherapy ; Clofarabine ; Cytarabine ; Acute leukemia ; Erythroderma ; Palmar–plantar erythrodysesthesia
• 刊名：Cancer Chemotherapy and Pharmacology
• 出版年：2014
• 出版时间：August 2014
• 年：2014
• 卷：74
• 期：2
• 页码：303-307
• 全文大小：310 KB
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• 作者单位：Bingnan Zhang (1)
  Jean Bolognia (2)
  Peter Marks (3)
  Nikolai Podoltsev (3)
  
  1. Yale School of Medicine, 333 Cedar St, New Haven, CT, 06520, USA
  2. Department of Dermatology, Yale School of Medicine, 333 Cedar St, New Haven, CT, 06520, USA
  3. Section of Hematology, Department of Internal Medicine, Yale School of Medicine, 333 Cedar St, New Haven, CT, 06520, USA
  
• ISSN：1432-0843

文摘

Purpose Skin toxicity is associated with a number of different chemotherapeutic agents used to treat acute leukemias. The term “toxic erythema of chemotherapy-(TEC) has been coined to describe a spectrum of skin findings, ranging from palmar–plantar erythrodysesthesia to erythema of major body folds, with erythroderma representing its most severe form. To clarify the types and frequencies of cutaneous reactions associated with clofarabine plus cytarabine chemotherapy and to compare these to those observed with clofarabine alone, we reviewed our institutional experience over a 5-year period. Methods We reviewed the medical records of 49 patients who were treated with either regimen for acute leukemia. To facilitate comparison of the cutaneous toxicities, only patients treated with clofarabine 40?mg/m2 daily for 5?days (days 1-) with or without cytarabine 1?g/m2 daily for 5?days (days 2-) were included. Results Ten patients were treated with clofarabine alone, and 40 patients received clofarabine plus cytarabine; one patient received both regimens. Treatment-associated skin toxicity developed 3-?days following the initiation of chemotherapy and was more common in the group receiving the two-drug combination as compared to those receiving clofarabine alone [22/40 (55?%) vs. 1/10 (10?%) respectively, p?=?0.014]. The majority of chemotherapy-related cutaneous side effects represented TEC. Conclusions Cutaneous toxicity was common and more frequent in the clofarabine plus cytarabine group when compared to patients treated with clofarabine alone. This finding is relevant for both clinicians and patients.