1
|
Solís-Armenta R, Rodríguez-Rodríguez S, Hernández-Pérez AP, Paulina-Zapata N, Delgado N, Montano-Figueroa EH, Leyto F, Solís-Poblano JC, Gómez-De León A, Amador LF, García-Castillo C, Martínez-Hernández R, Saldaña-Velazquez HA, Valero-Saldaña LM, Terreros E, Jimenez-Ochoa MA, Milán-Salvatierra A, Colunga-Pedraza PR, Gómez-Almaguer D, Alcivar LM, Apodaca-Chávez E, Meza M, Yocupicio F, Sánchez-Díaz S, Demichelis-Gómez R. Understanding factors limiting hematopoietic cell transplantation for acute myeloid leukemia patients in Mexico: a comprehensive analysis. Ann Hematol 2024:10.1007/s00277-024-05956-w. [PMID: 39177797 DOI: 10.1007/s00277-024-05956-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2024] [Accepted: 08/16/2024] [Indexed: 08/24/2024]
Abstract
Acute myeloid leukemia (AML) is the most frequent indication for allogeneic hematopoietic cell transplantation (alloHCT) worldwide; social and health system barriers limit its access. We performed an observational retrospective analysis in Mexico to analyze factors limiting alloHCT in fit patients with AML. With a median follow-up of 11.8 months, 301 patients were included, with a median age of 42; 33.5% were classified as adverse risk. Despite 215 patients (92.5%) achieving complete remission, only 103 (34%) had HLA-typing: 44.5% had a matched-sibling donor (MSD), 32% a haploidentical donor, and 23.5% had no donor. Only 23.5% of patients had an HCT consult; merely 36 underwent an HCT: 30 alloHCT, and six an autologous HCT. Age ≥ 60 years, HCT-CI score ≥ three, and the absence of a local transplant program negatively influenced HLA typing likelihood. Patients with an MSD had a higher alloHCT likelihood. The cumulative incidence of transplant (CIT) and relapse (CIR) at 6 and 12 months was 7.3% and 13.8%, 8.2% and 13%, respectively. A lack of HLA-typing was associated with a lower CIT (p < 0.001) and higher CIR (p = 0.033) (HR 11.72, CI 95% 4.39-31.27, p < 0.001), while the presence of an MSD was associated with a higher CIT (p = 0.002) (HR 4.22, CI 95% 1.89-9.44, p < 0.001). The main reasons hindering alloHCT are the lack of access to HLA-typing tests and the absence of an MSD. A national donor registry and improved HLA-typing accessibility are critical for increasing alloHCT access in Mexico.
Collapse
Affiliation(s)
- Rubén Solís-Armenta
- Department of Hematology, Instituto Nacional De Cancerología, Mexico City, Mexico
| | - Sergio Rodríguez-Rodríguez
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Andrea Priscila Hernández-Pérez
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Nidia Paulina-Zapata
- Department of Hematology, Instituto Nacional De Cancerología, Mexico City, Mexico
| | - Nancy Delgado
- Department of Hematology, Hospital de Especialidades, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | | | - Faustino Leyto
- Department of Hematology, Hospital Juarez de Mexico, Mexico City, Mexico
| | - Juan Carlos Solís-Poblano
- Department of Hematology, Centro Medico Nacional Manuel Avila Camacho, Instituto Mexicano del Seguro Social, Puebla, Mexico
| | - Andrés Gómez-De León
- Department of Hematology, Instituto Nacional De Cancerología, Mexico City, Mexico
| | - Lauro Fabian Amador
- Department of Hematology, Hospital Regional de Alta Especialidad del Bajio, Leon, Guanajuato, Mexico
| | - Carolina García-Castillo
- Department of Hematology, Hospital Central Militar, Secretaría de la Defensa Nacional, Mexico City, Mexico
| | - Ramon Martínez-Hernández
- Department of Hematology, Hospital Regional de Alta Especialidad de Ciudad Victoria, Ciudad Victoria, Tamaulipas, Mexico
| | - Hugo Alexis Saldaña-Velazquez
- Department of Hematology, Hospital Regional de Alta Especialidad de Ciudad Victoria, Ciudad Victoria, Tamaulipas, Mexico
| | | | - Eduardo Terreros
- Department of Hematology, Hospital de Especialidades, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Marco Alejandro Jimenez-Ochoa
- Department of Hematology, Hospital de Especialidades, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | | | - Perla Rocío Colunga-Pedraza
- Department of Hematology, Universidad Autónoma de Nuevo León. Facultad de Medicina y Hospital Universitario Dr. Jose Eleuterio González, Monterrey, Nuevo Leon, Mexico
| | - David Gómez-Almaguer
- Department of Hematology, Universidad Autónoma de Nuevo León. Facultad de Medicina y Hospital Universitario Dr. Jose Eleuterio González, Monterrey, Nuevo Leon, Mexico
| | - Luisa M Alcivar
- Department of Hematology, Hospital Central Militar, Secretaría de la Defensa Nacional, Mexico City, Mexico
| | - Elia Apodaca-Chávez
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Mario Meza
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Fabiola Yocupicio
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Susana Sánchez-Díaz
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Roberta Demichelis-Gómez
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico.
| |
Collapse
|
2
|
Gómez-De León A, Demichelis-Gómez R, da Costa-Neto A, Gómez-Almaguer D, Rego EM. Acute myeloid leukemia: challenges for diagnosis and treatment in Latin America. HEMATOLOGY (AMSTERDAM, NETHERLANDS) 2023; 28:2158015. [PMID: 36607152 DOI: 10.1080/16078454.2022.2158015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE to review the current diagnostic and therapeutic landscape of AML in Latin America as a reflection of other low- and middle-income countries and regions of the world. Encompassing both acute promyelocytic and non-promyelocytic disease types. METHODS We reviewed the literature and study registries concerning epidemiological features of patients with AML/APL treated in Latin America, as well as evaluated diagnostic and genetic stratification and patient fitness assessment challenges, the importance of early mortality and supportive care capacity, intensive and non-intensive chemotherapy alternatives, consolidation, and maintenance strategies including novel agents and hematopoietic stem cell transplantation. RESULTS Although most of the current technologies and treatment options are available in the region, a significant fraction of patients have only limited access to them. In addition, mortality in the first weeks from diagnosis is higher in the region compared to developed countries. CONCLUSIONS Disparities in access to technologies, supportive care capacity, and availability of novel agents and HSCT hinder results in our region, reflecting barriers common to other LMICs. Recent developments in the diagnosis and treatment of this disease must be implemented through education, collaborative clinical research, and advocacy to improve outcomes.
Collapse
Affiliation(s)
- Andrés Gómez-De León
- Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Universiadad Autónoma de Nuevo León, Monterrey, Mexico
| | - Roberta Demichelis-Gómez
- Department of Hematology, Instituto Nacional de Cinecias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Abel da Costa-Neto
- Department of Hematology, D'or Institute for Research and Education, São Paulo, Brazil
| | - David Gómez-Almaguer
- Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Universiadad Autónoma de Nuevo León, Monterrey, Mexico
| | | |
Collapse
|
3
|
Silva WFD, Mendes FR, Melo RDCBD, Velloso EDRP, Rocha V, Rego EM. Assessing the impact of prophylactic anidulafungin during remission induction of acute myeloid leukemia - A propensity-score matching analysis. J Mycol Med 2023; 33:101434. [PMID: 37683564 DOI: 10.1016/j.mycmed.2023.101434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 06/13/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023]
Abstract
INTRODUCTION Invasive fungal infection (IFI) accounts for substantial morbidity during the treatment of acute myeloid leukemia (AML) in adults. Antifungal prophylaxis (AP) is needed during intensive chemotherapy, and posaconazole is not widely available. In this study, we aimed to examine the impact of prophylactic anidulafungin during intensive AML remission induction. METHODS This is a retrospective cohort encompassing newly diagnosed AML adult patients. All subjects received intensive chemotherapy and were divided into three groups: patients who did not receive any AP and patients who received fluconazole (150-400 mg/day) or anidulafungin (100 mg/day). RESULTS During AML induction, 82 patients did not receive AP, 108 and 14 patients received anidulafungin and fluconazole, respectively. IFI incidence was 27%, classified as possible, probable, and proven in 65, 2 and 33%, respectively. Multivariable analysis showed that lower neutrophil counts are associated with IFI (OR = 2.8), whereas age, genetic classification, and lymphocyte counts were not. To examine the impact of anidulafungin in comparison with 'no AP', a propensity score matching analysis was performed. Use of anidulafungin was not related to less IFI during induction, while neutrophil counts remained significant. Patients under prophylactic anidulafungin received less amphotericin B (p < 0.001) but not voriconazole (p = 0.49). DISCUSSION To our knowledge, this is the first study addressing the role of anidulafungin during AML induction. Here, the incidence of mold infections did not decrease with AP, suggesting that in a setting with a high incidence of IFI, broad spectrum AP might be more suitable.
Collapse
Affiliation(s)
- Wellington Fernandes da Silva
- Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology (LIM-31), Division of Hematology and Cell Therapy, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 251, Cerqueira César, São Paulo, SP CEP 01246-000, Brazil; Instituto do Cancer do Estado de São Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-000, Brazil.
| | - Fernanda Rodrigues Mendes
- Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology (LIM-31), Division of Hematology and Cell Therapy, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 251, Cerqueira César, São Paulo, SP CEP 01246-000, Brazil; Instituto do Cancer do Estado de São Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-000, Brazil
| | - Raphael da Costa Bandeira de Melo
- Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology (LIM-31), Division of Hematology and Cell Therapy, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 251, Cerqueira César, São Paulo, SP CEP 01246-000, Brazil; Instituto do Cancer do Estado de São Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-000, Brazil
| | - Elvira Deolinda Rodrigues Pereira Velloso
- Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology (LIM-31), Division of Hematology and Cell Therapy, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 251, Cerqueira César, São Paulo, SP CEP 01246-000, Brazil; Instituto do Cancer do Estado de São Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-000, Brazil
| | - Vanderson Rocha
- Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology (LIM-31), Division of Hematology and Cell Therapy, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 251, Cerqueira César, São Paulo, SP CEP 01246-000, Brazil; Instituto do Cancer do Estado de São Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-000, Brazil
| | - Eduardo Magalhaes Rego
- Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology (LIM-31), Division of Hematology and Cell Therapy, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 251, Cerqueira César, São Paulo, SP CEP 01246-000, Brazil; Instituto do Cancer do Estado de São Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-000, Brazil
| |
Collapse
|
4
|
Noor S, Haidary AM, Yosufzai AW, Niazai M, Noor S, Nasir N, Shinwari A, Saadaat R. Demographic and clinical characteristics of acute myeloid leukaemia diagnosed and treated at the tertiary level in Afghanistan. Br J Haematol 2023; 203:404-410. [PMID: 37609793 DOI: 10.1111/bjh.19029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/19/2023] [Accepted: 07/24/2023] [Indexed: 08/24/2023]
Abstract
A retrospective case series design was conducted to elucidate the demographic features of acute myeloid leukaemia in Afghanistan. This study was conducted at Jamhuriat Hospital and French Medical Institute for Mothers and Children, Kabul, Afghanistan. A total of 203 patients with AML diagnosed and managed at Jamhuriat Hospital from 1 March 2018 to 31 March 2020, were included in the current study. The median age at diagnosis was 27 years. Housewives represented the largest subset of patients from an occupational point of view constituting 37.44% of the total sample population and 81.72% of the female population, followed by 20.69% patients who were students of which 14.77% were male and 5.91% were female, and 17.24% were farmers, which constituted 31.81% of the male population. Similarly, 69.95% of individuals presented with infection, 57.14% presented with bone tenderness, 46.3% presented with bleeding tendencies, 55.66% had hepatomegaly and/or splenomegaly, and 27.58% of patients had lymphadenopathy. Considering the chemotherapeutic regime, 64.53% of the individuals received standard 7 + 3 (cytarabine + daunorubicin) induction regimen, 10.68% of those received 5 + 2 re-induction chemotherapy (cytarabine + daunorubicin). 10.84% who were diagnosed with acute promyelocytic leukaemia received all-trans-retinoic acid + arsenic trioxide, while 5.42% of patients defaulted chemotherapy. High prevalence was noted in young individuals. Similarly, a high proportion of patients were constituted by housewives.
Collapse
Affiliation(s)
- Sarah Noor
- Department of Haemato-Oncology, Jamhuriat Hospital, Kabul, Afghanistan
| | - Ahmed Maseh Haidary
- Department of Pathology, French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan
| | | | - Mirajan Niazai
- Department of Haemato-Oncology, Jamhuriat Hospital, Kabul, Afghanistan
| | - Sahar Noor
- Department of Paediatric Medicine, French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan
| | - Najla Nasir
- Department of Medicine, Rabia Balkhi Women's Hospital, Kabul, Afghanistan
| | - Ayub Shinwari
- Department of Haemato-Oncology, Jamhuriat Hospital, Kabul, Afghanistan
| | - Ramin Saadaat
- Department of Pathology, French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan
| |
Collapse
|
5
|
De la Garza-Salazar F, Colunga-Pedraza PR, Gómez-Almaguer D, García-Zárate VA, Gómez-De León A. Low dose venetoclax plus itraconazole outpatient induction in newly diagnosed acute myeloid leukemia: A phase 2 study. Leuk Res 2023; 133:107373. [PMID: 37633156 DOI: 10.1016/j.leukres.2023.107373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/11/2023] [Accepted: 08/21/2023] [Indexed: 08/28/2023]
Abstract
Data concerning venetoclax and azacitidine (Ven/Aza) as first-line therapy for newly diagnosed acute myeloid leukemia (ND-AML) in candidates for intensive chemotherapy are limited, and outpatient induction regimens in ND-AML have been poorly explored. The enzyme CYP3A4 metabolizes Venetoclax. Conversely, itraconazole is a strong CYP3A4 inhibitor; thus, it produces a 75 % reduction in the dose and cost of venetoclax. This phase 2 trial assessed the feasibility, safety, and efficacy of outpatient induction with venetoclax 100 mg daily from days 1-21, itraconazole 100 mg twice daily from days 1-21, and azacytidine 100 mg subcutaneously, once daily from days 1-7. Fifteen adults with ND-AML were enrolled. The median age was 53 (range 25-73) and twelve (80 %) were considered candidates for intensive chemotherapy. Nine (60 %) subjects started treatment as outpatients,. The first treatment cycle completion in the outpatient setting was achieved in 77.7 %. Early 14-day, 30-day, and 60-day mortality rates were 6.7 %, 13.3 %, and 13.3 %, respectively. Composite CR/CRi after the first and second treatment cycles were 53.9 % and 85.7 %, respectively. Common adverse events included hematological and gastrointestinal toxicities. Outpatient induction with low-dose venetoclax plus itraconazole is feasible, safe, and has acceptable preliminary efficacy in ND-AML patients. This trial was registered in www.clinicaltrials.gov as #NCT05048615.
Collapse
Affiliation(s)
- Fernando De la Garza-Salazar
- Univerisdad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Hematology service, Internal Medicine Department
| | - Perla Rocío Colunga-Pedraza
- Univerisdad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Hematology service, Internal Medicine Department
| | - David Gómez-Almaguer
- Univerisdad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Hematology service, Internal Medicine Department
| | - Valeria Abigail García-Zárate
- Univerisdad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Hematology service, Internal Medicine Department
| | - Andrés Gómez-De León
- Univerisdad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Hematology service, Internal Medicine Department.
| |
Collapse
|
6
|
De la Garza-Salazar F, Gómez-De León A, Gómez-Almaguer D, Colunga-Pedraza PR. Vinblastine as a bridge to 7 + 3 in acute myeloid leukaemia. Ann Hematol 2023; 102:487-489. [PMID: 36651981 DOI: 10.1007/s00277-022-05048-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 11/08/2022] [Indexed: 01/19/2023]
Affiliation(s)
- Fernando De la Garza-Salazar
- Hematology Service, Hospital Universitario "Dr, José Eleuterio González", Universidad Autónoma de Nuevo León, Francisco I. Madero and Avenida Gonzalitos, Mitras Centro, Z.P. 64460, Monterrey, NL, Mexico
| | - Andrés Gómez-De León
- Hematology Service, Hospital Universitario "Dr, José Eleuterio González", Universidad Autónoma de Nuevo León, Francisco I. Madero and Avenida Gonzalitos, Mitras Centro, Z.P. 64460, Monterrey, NL, Mexico
| | - David Gómez-Almaguer
- Hematology Service, Hospital Universitario "Dr, José Eleuterio González", Universidad Autónoma de Nuevo León, Francisco I. Madero and Avenida Gonzalitos, Mitras Centro, Z.P. 64460, Monterrey, NL, Mexico
| | - Perla R Colunga-Pedraza
- Hematology Service, Hospital Universitario "Dr, José Eleuterio González", Universidad Autónoma de Nuevo León, Francisco I. Madero and Avenida Gonzalitos, Mitras Centro, Z.P. 64460, Monterrey, NL, Mexico.
| |
Collapse
|
7
|
Kamat G, Rao M, Goni D, Balikai G. Acute myeloid leukemia: Comparing French–American–British classification with immunophenotype and cytogenetics. BLDE UNIVERSITY JOURNAL OF HEALTH SCIENCES 2022. [DOI: 10.4103/bjhs.bjhs_138_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
8
|
Predictive factors associated with induction-related death in acute myeloid leukemia in a resource-constrained setting. Ann Hematol 2021; 101:147-154. [PMID: 34676435 DOI: 10.1007/s00277-021-04687-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/27/2021] [Indexed: 12/19/2022]
Abstract
Despite advances in supportive measures, acute myeloid leukemia (AML) remission induction still has a high mortality rate in real-world studies as compared to prospective reports. We analyzed data from 206 AML adult patients treated with conventional chemotherapy. The primary endpoint was the 60-day mortality rate, aiming to find risk factors and to examine the role of anti-infection prophylaxis. The 60-day mortality rate was 26%, raising to 41% among those older than 60 years. Complete response was documented at the end of induction in 49%. The final survival model showed that age > 60 years (HR 3.2), Gram-negative colonization (HR 3), monocytic AML (HR 1.8), C-reactive protein (CRP) > 15 mg/dL (HR 10), and an adverse risk in the genetic stratification (HR 3) were associated with induction death. Multidrug-resistant bacteria colonization, thrombosis, and AKI were documented in 71%, 12%, and 66% of the cohort, respectively. Antibacterial and antifungal prophylaxis did not improve outcomes in this study. Our report corroborated the higher mortality during AML induction compared to real-world data from the USA and Europe. In line with other publications, age and cytogenetic stratification influenced early death in this cohort. Noticeably, Gram-negative colonization, monocytic AML, and CRP were also significant to early mortality.
Collapse
|
9
|
Vera-Lastra O, Olvera-Acevedo A, Pulido-Díaz N, Quintal-Ramírez MDJ, Ordoñez-González I, Cimé-Aké E, Cruz-Domínguez MP, Medina G. Transformation of a myelodysplastic syndrome to acute myeloid leukemia and concurrent necrotizing sweet syndrome. Dermatol Reports 2021; 13:9017. [PMID: 33824709 PMCID: PMC8018258 DOI: 10.4081/dr.2021.9017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 02/15/2021] [Indexed: 12/05/2022] Open
Abstract
The Sweet's syndrome, is an inflammatory skin disorder characterized by extensive infiltration of neutrophils in the dermis with extension to the subcutis, known as acute febrile neutrophilic dermatosis. It may occur as a paraneoplastic syndrome. To our knowledge, there are currently few reports about transformation of a myelodysplastic syndrome to acute myeloid leukemia and concurrent necrotizing Sweet syndrome in the literature. Herein we describe an unusual case in a young patient with these characteristics that evolved to a fatal outcome.
Collapse
Affiliation(s)
- Olga Vera-Lastra
- Internal Medicine Department, Hospital de Especialidades Centro Médico Nacional La Raza, IMSS, Mexico City
- Universidad Nacional Autónoma de México, Mexico City
| | - Arturo Olvera-Acevedo
- Internal Medicine Department, Hospital de Especialidades Centro Médico Nacional La Raza, IMSS, Mexico City
- Universidad Nacional Autónoma de México, Mexico City
| | - Nancy Pulido-Díaz
- Dermatology Department, Hospital de Especialidades Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City
| | - Marissa de Jesús Quintal-Ramírez
- Pathology Department, Hospital de Especialidades Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City
| | | | - Erik Cimé-Aké
- Internal Medicine Department, Hospital de Especialidades Centro Médico Nacional La Raza, IMSS, Mexico City
- Universidad Nacional Autónoma de México, Mexico City
| | - María Pilar Cruz-Domínguez
- Universidad Nacional Autónoma de México, Mexico City
- Translational Research Unit, Hospital de Especialidades Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City
| | - Gabriela Medina
- Universidad Nacional Autónoma de México, Mexico City
- Research Division, Hospital de Especialidades Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| |
Collapse
|