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Vaidya P, Wang HY, Don MD, Hinds BR, Mangan JK. IDH2-mutated near ETP-ALL with aggressive leukemia cutis and brisk response to venetoclax and decitabine. Leuk Res Rep 2023; 21:100408. [PMID: 38269085 PMCID: PMC10805932 DOI: 10.1016/j.lrr.2023.100408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 12/11/2023] [Accepted: 12/29/2023] [Indexed: 01/26/2024] Open
Abstract
Near early T-cell precursor acute lymphoblastic leukemia (ETP-ALL) is a rare hematologic malignancy, for which second line therapeutic options are limited. T-cell leukemias are also rarely associated with leukemia cutis, which is more often seen in leukemias of myeloid origin. We present the case of an adult male diagnosed with near ETP-ALL, with IDH2 and DNMT3A mutations, suggestive of a myeloid origin, and leukemia cutis. After the patient progressed on hyper-CVAD and nelarabine, we treated him with the BCL-2 inhibitor venetoclax and the hypomethylating agent decitabine. The regimen induced a rapid bone marrow response and resolution of the leukemia cutis.
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Affiliation(s)
- Poorva Vaidya
- Department of Internal Medicine, Division of Hematology-Oncology, Moores Cancer Center, University of California, San Diego, La Jolla, CA, United States
| | - Huan-You Wang
- Department of Pathology, University of California, San Diego, La Jolla, CA, United States
| | - Michelle D. Don
- Department of Pathology, University of California, San Diego, La Jolla, CA, United States
| | - Brian R. Hinds
- Department of Dermatology, University of California, San Diego, La Jolla, CA, United States
| | - James K. Mangan
- Department of Internal Medicine, Division of Blood and Marrow Transplantation, Moores Cancer Center, University of California, San Diego, La Jolla, CA, United States
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Nazaretyan S, Ali A, Yaghmour G, Tong A, Castillo V, Rodrigues S, Ladha A, Woan K, Tam E, Shi SY, Bateshansky D, Chaudhary PM. Unique challenges to diagnosing sweet syndrome following induction chemotherapy for relapsed Acute Myeloid Leukemia (AML): A case and brief-review. Respir Med Case Rep 2023; 46:101922. [PMID: 37841284 PMCID: PMC10570145 DOI: 10.1016/j.rmcr.2023.101922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 09/04/2023] [Accepted: 09/29/2023] [Indexed: 10/17/2023] Open
Abstract
Background Sweet Syndrome (SS) is a rare inflammatory skin condition characterized by the sudden appearance of tender, erythematous or violaceous papules, plaques, and nodules typically found on the face, neck, shoulder, upper extremities, and trunk. Often, SS is difficult to diagnose because of its various non-specific manifestations, including fever, arthralgia, myalgia and ocular involvement. In most cases described in literature, cutaneous and pulmonary symptoms of SS present in a concomitant manner. Several reported cases of pulmonary SS have shown that if left untreated, acute respiratory distress syndrome can ensue and progress to fatal respiratory failure. Case report A 58-year-old female with acute myeloid leukemia (AML) secondary to chronic lymphocytic leukemia (CLL) presented with new nodular lesions, dyspnea, and fevers. Chest X-ray revealed pulmonary infiltrates. The patient developed new facial lesions and worsening hypoxic respiratory failure. Further infectious workup was negative. She was found to have SS with pulmonary involvement and initiated on high-dose intravenous (IV) steroids with marked clinical improvement. Conclusions Major and minor criteria for the diagnosis of lung-associated SS should be carefully evaluated, especially when a biopsy is unavailable. The following case report describes the clinical course and outcomes from treatment for this patient.
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Affiliation(s)
- Samvel Nazaretyan
- University of Southern California, Keck School of Medicine, LA, USA
- Nohl Division of Hematology and Center for the Study of Blood Diseases, Department of Medicine, Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Amir Ali
- University of Southern California, Keck School of Medicine, LA, USA
- Nohl Division of Hematology and Center for the Study of Blood Diseases, Department of Medicine, Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - George Yaghmour
- University of Southern California, Keck School of Medicine, LA, USA
- Nohl Division of Hematology and Center for the Study of Blood Diseases, Department of Medicine, Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Anhthy Tong
- University of Southern California, Keck School of Medicine, LA, USA
- Nohl Division of Hematology and Center for the Study of Blood Diseases, Department of Medicine, Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Vanessa Castillo
- University of Southern California, Keck School of Medicine, LA, USA
- Nohl Division of Hematology and Center for the Study of Blood Diseases, Department of Medicine, Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Sonia Rodrigues
- University of Southern California, Keck School of Medicine, LA, USA
- Nohl Division of Hematology and Center for the Study of Blood Diseases, Department of Medicine, Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Abdullah Ladha
- University of Southern California, Keck School of Medicine, LA, USA
- Nohl Division of Hematology and Center for the Study of Blood Diseases, Department of Medicine, Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Karrune Woan
- University of Southern California, Keck School of Medicine, LA, USA
- Nohl Division of Hematology and Center for the Study of Blood Diseases, Department of Medicine, Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Eric Tam
- University of Southern California, Keck School of Medicine, LA, USA
- Nohl Division of Hematology and Center for the Study of Blood Diseases, Department of Medicine, Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Samantha Y. Shi
- University of Southern California, Keck School of Medicine, LA, USA
- Nohl Division of Hematology and Center for the Study of Blood Diseases, Department of Medicine, Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - David Bateshansky
- University of Southern California, Keck School of Medicine, LA, USA
- Nohl Division of Hematology and Center for the Study of Blood Diseases, Department of Medicine, Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Preet M. Chaudhary
- University of Southern California, Keck School of Medicine, LA, USA
- Nohl Division of Hematology and Center for the Study of Blood Diseases, Department of Medicine, Norris Comprehensive Cancer Center, Los Angeles, CA, USA
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Bechtold A, Owczarczyk‐Saczonek A. Atypical presentation of Sweet syndrome with nodular erythema and oral ulcerations provoked by Ad26.COV2.S SARS-CoV-2 vaccination and review of literature. Dermatol Ther 2022; 35:e15923. [PMID: 36219526 PMCID: PMC9874627 DOI: 10.1111/dth.15923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/05/2022] [Accepted: 10/08/2022] [Indexed: 01/27/2023]
Abstract
The aim of this article is to present the case of acute febrile neutrophilic dermatosis (Sweet syndrome-SS) after Ad26.COV2.S vaccination against SARS-CoV-2. To the best of our knowledge, this is the second case of SS provoked by this specific vaccine. What is more, the mildly symptomatic beginning of the disease, later followed by typical SS manifestation with a variety of symptoms including nodular erythema of the feet and oral ulcerations, made it very challenging to establish the diagnosis. The article focuses on the current literature on the acute febrile neutrophilic dermatosis, along with the coexistence with other neutrophilic dermatoses and anti-SARS-CoV-2 vaccinations as provoking factors. It emphasizes the necessity for sharing the knowledge and experience on the subject of SS's clinical manifestations and underlying causes to facilitate prompt diagnosis and introduction of appropriate treatment.
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Affiliation(s)
- Agata Bechtold
- Dermatology, Sexually Transmitted Diseases and Clinical Immunology ClinicThe Municipal Polyclinical Hospital in OlsztynOlsztynPoland
- Department of Psychodermatology, Department of Pulmonology, Rheumatology and Clinical ImmunologyMedical University of LodzLodzPoland
| | - Agnieszka Owczarczyk‐Saczonek
- Department and Clinic of Dermatology, Sexually Transmitted Diseases and Clinical ImmunologyUniveristy of Warmia and Mazury in OlsztynOlsztynPoland
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