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Multiple pretibial cutaneous relapses of acute myeloblastic leukemia after allogeneic BMT

Bone Marrow Transplantation volume 43, pages 819–820 (2009)Cite this article

Leukemia cutis is the infiltration of the skin by malignant hematopoietic cells. Any type of leukemia can disseminate to the skin, but this occurs most frequently in myeloid leukemias with monocytic differentiation, which presents with specific cutaneous involvement in ∼25–31% of cases, and less frequently in AML, in 10% of cases.1, 2, 3 It is widely recognized that the onset of cutaneous involvement in leukemia as a specific skin infiltration carries a poor prognosis.4 We report the case of a woman diagnosed with AML who underwent allogeneic BMT and who presented with six consecutive cutaneous relapses, always confined to the same area and in the absence of peripheral blood or BM involvement.

A 37-year-old woman diagnosed with AML type M2, showing the chromosomal translocation t (10;11)(q22;q23) and mixed lineage leukemia gene rearrangement by FISH analysis, received an allogeneic BMT from a HLA-identical female sibling in December 2000, after an ablative conditioning regimen, achieving CR and full donor chimerism. The patient developed chronic pulmonary GVHD since 2001. She remained in hematological CR and full donor chimerism for 3 years. From 2003 to June 2008, she suffered six consecutive localized cutaneous relapses confined to the skin of her left leg without any evidence of peripheral blood or BM involvement. All the relapses have been confirmed by skin biopsy and treated with local radiotherapy, resulting in complete resolution. Nonetheless, subsequent relapses appeared after an interval of ∼6 months. The patient never received systemic chemotherapy or donor lymphocyte infusion as treatment.

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Authors and Affiliations

  1. Department of Dermatology, Hospital Universitario de La Princesa, Madrid, Spain

    Á Juárez, R Goiriz, I Domínguez-Fernández & A García-Diez

  2. Department of Hematology, Hospital Universitario de La Princesa, Madrid, Spain

    V Gómez-García de Soria & R Cámara

  3. Department of Pathology, Hospital Universitario de La Princesa, Madrid, Spain

    J Fraga

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  1. Á Juárez
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  2. R Goiriz
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  7. A García-Diez
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Correspondence to Á Juárez.

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Juárez, Á., Goiriz, R., Domínguez-Fernández, I. et al. Multiple pretibial cutaneous relapses of acute myeloblastic leukemia after allogeneic BMT. Bone Marrow Transplant 43, 819–820 (2009). https://doi.org/10.1038/bmt.2008.402

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