Grille Sofía, Guadagna Regina, Boada Matilde, Irigoin Victoria, Stevenazzi Mariana, Guillermo Cecilia, Díaz Lilián
Cátedra de Hematología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay. E-mail:
Medicina (B Aires). 2013;73(6):535-8.
Cytarabine is an antimetabolite used in the treatment of acute myeloid leukemia (AML). It has many adverse effects as: myelosuppression, toxic reactions involving central nervous system, liver, gastrointestinal tract, eyes or skin. Dermatologic toxicity is often described as rare; nevertheless there are differences in the reported frequency. We performed a retrospective study including all AML treated with chemotherapy that involved cytarabine between 1st July of 2006 and 1st July of 2012; 46 patients were included with a median age of 55 years. The overall incidence of skin reactions was 39% (n = 18). Sex, age, history of atopy, history of drug reactions, or dose of cytarabine used, were not associated with them. Skin reactions were observed from 2 to 8 days after treatment started. Considering injury degree: 27.8% had grade 1, 38.9% grade 2 and 33.3% grade 3. We did not find any injury grade 4 or death associated with skin toxicity. As for the type of injury: 55.6% presented macules, 22.2% papules and 22.2% erythema. Lesions distribution was diffuse in 52% of patients, acral in 39.3%, and at flexural level in 8.7%. Adverse cutaneous reactions secondary to the administration of cytarabine are frequent in our service and include some cases with severe involvement. Although these reactions usually resolve spontaneously, they determine an increased risk of infection and a compromise of the patient quality of life.
阿糖胞苷是一种用于治疗急性髓系白血病（AML）的抗代谢药物。它有许多不良反应，如骨髓抑制、涉及中枢神经系统、肝脏、胃肠道、眼睛或皮肤的毒性反应。皮肤毒性通常被描述为罕见；然而，报告的频率存在差异。我们进行了一项回顾性研究，纳入了2006年7月1日至2012年7月1日期间所有接受含阿糖胞苷化疗的AML患者；共纳入46例患者，中位年龄为55岁。皮肤反应的总体发生率为39%（n = 18）。性别、年龄、特应性病史、药物反应史或所用阿糖胞苷的剂量与皮肤反应均无关联。皮肤反应在治疗开始后2至8天出现。考虑损伤程度：27.8%为1级，38.9%为2级，33.3%为3级。我们未发现任何4级损伤或与皮肤毒性相关的死亡病例。至于损伤类型：55.6%表现为斑疹，22.2%为丘疹，22.2%为红斑。52%的患者皮损分布弥漫，39.3%累及肢端，8.7%累及屈侧部位。在我们的科室，阿糖胞苷给药继发的不良皮肤反应很常见，包括一些严重受累的病例。尽管这些反应通常会自行缓解，但它们会增加感染风险并影响患者的生活质量。
