Table 1.
Characteristics of 35 patients undergoing 37 skin biopsies during hospitalization for intensive chemotherapy for AML.
| Characteristics | Value (based on 37 biopsies) |
|---|---|
| Male gender, n (%) | 18 (49) |
| Age (years), median (range) | 59 (20–79) |
| Diagnosis, n (%) | |
| AML, other than APL | 35 (95) |
| APL | 2 (5) |
| Biopsy timing, n (%) | |
| During induction | |
| At presentation, before chemotherapy | 8 (22) |
| During or post-induction treatment | 26 (70) |
| During consolidation | 3 (8) |
| Time from chemotherapy (days), median (range)* | 10 (2–51) |
| Regimen prior to skin eruption, n (%)* | |
| Induction with daunorubicin + ARA-C (“3 + 7”) | 23 (79) |
| ARA-C as consolidation | 3 (10) |
| Salvage protocol (high dose ARA-C + mitoxantrone) | 1 (4) |
| ATRA + idarubicin | 2 (7) |
| Grade of rash, n (%)† | |
| 1 | 18 (53) |
| 2 | 9 (26) |
| 3 | 5 (15) |
| 4 | 2 (6) |
| Rash morphology | |
| Maculopapular | 16 (43) |
| Nodular | 4 (11) |
| Vesicular / pustular | 4 (11) |
| Ecthyma | 3 (8) |
| Purpura | 1 (3) |
| Striae | 2 (5) |
| Undetermined | 7 (19) |
| Rash distribution, n (% of total areas involved)‡ | |
| Head and neck | 5 (11) |
| Trunk | 15 (33) |
| Limbs | 23 (51) |
| Missing data | 2 (4) |
| Laboratory data at time of biopsy | |
| Neutrophil count (per microL), median (range) | 200 (0–9700) |
| Neutropenia (neutrophils < 500 cells/microL), n (%) | 23 (62) |
| Platelet count (per microL), median (range) | 127,000 (6000–398,000) |
| PT (seconds), median (range) | 15 (11–21) |
| PTT (seconds), median (range) | 31 (17–47) |
| Fever at time of rash, n (%) | 16 (43) |
| Bacteremia at time of biopsy, n (%) | 4 (11) |
*For the 29 skin eruptions appearing after chemotherapy commencement.
†Data available for 34/37 skin biopsies. Grade according to CTCAE, version 512.
‡If rash involved more than one body part, it was counted more than once. Value represents percent of total areas involved in all patients (n = 45).
AML acute myeloid leukemia, APL acute promyelocytic leukemia, 3 + 7 daunorubicin and cytarabine, ARA-C cytosine arabinoside, ATRA all trans retinoic acid, CTCAE Common Terminology Criteria for Adverse Events, PT prothrombin time, PTT partial thromboplastin time.