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Differentiation syndrome during ivosidenib treatment with immunohistochemistry showing isocitrate dehydrogenase R132H mutation

J Cutan Pathol. 2021-06-01; 
Mika M Tabata, Melissa Chase, Bernice Y Kwong, Roberto A Novoa, Sebastian Fernandez-Pol
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摘要

We report a case of differentiation syndrome in a patient receiving the IDH1 inhibitor ivosidenib, with skin biopsy showing isocitrate dehydrogenase (IDH) R132H-mutated leukemia cutis. A 72-year-old man with IDH1-mutated acute myeloid leukemia (AML), status-post allogeneic cell transplantation, on ivosidenib for six months, was admitted for culture-negative neutropenic fever, pink and purpuric plaques and patches on the legs, abdomen and back, edema, hypotension, and shortness of breath. Skin biopsy revealed an infiltrate of atypical, immature, myeloperoxidase-positive mononuclear cells compatible with leukemia cutis or Sweet syndrome. Although dermal edema and interstitial neutrophilic infiltrate with karyorrh... More

关键词

AG-120, IDH R132H mutation, acute myeloid leukemia, differentiation syndrome, ivosidenib, leukemia cutis, targeted mutant IDH1 inhibitor