Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0023473 (chronic myeloid leukemia)
 18,916 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recurrent bilateral leg ulcers developed in two patients receiving hydroxyurea therapy during the chronic phase of chronic myelogenous leukemia. The ulcers were extremely painful and were associated with extensive edema and vasculitic papules. A small-vessel vasculitis with degeneration of collagen and ulceration was seen on biopsy. The ulcers did not respond to treatment with steroids or low-dose cyclophosphamide but gradually healed with local measures. The possible pathogenesis of ulcers in chronic myelogenous leukemia is discussed.
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PMID:Vasculitic leg ulcers in chronic myelogenous leukemia. 385 57

We report four cases of cutaneous lower leg ulcers associated with hydroxyurea treatment for myeloproliferative disorders. This association has been reported in one other series of patients who had chronic myelogenous leukemia and were treated with hydroxyurea. A review of the literature and survey of possible pathogenetic mechanisms is presented.
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PMID:Hydroxyurea and lower leg ulcers. 826 6

We report a 45-year-old male with chronic myelogenous leukemia (CML) who experienced skin ulcers of the left lateral malleolus and dorsum of both feet. He had been treated with hydroxyurea (HU) for 2 years. His leg ulcers improved after HU was discontinued. Skin biopsy of the ulcerated lesion revealed that the lesion is compatible with small vessel vasculitis, but circulating immune complexes (C1q, anti-C3d antibody) were negative. Although the precise mechanism of the skin ulcer is unknown, we must take into consideration the skin changes were secondary to hydroxyurea therapy in myeloproliferative disorders.
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PMID:[Bilateral leg ulcers with pathologic evidence of small vessel vasculitis by skin biopsy during hydroxyurea therapy of chronic myelogenous leukemia]. 909 64

Hydroxyurea is commonly used in the treatment of various hematologic disorders, e.g., chronic myelogenous leukemia (CML), polycythemia vera, and occasionally, at lower doses, for severe psoriasis vulgaris. Cutaneous side effects such as alopecia, diffuse hyperpigmentation, poikiloderma, atrophy of the skin, or nail changes occur, especially with long-term treatment. Painful leg ulcers in association with hydroxyurea have only rarely been reported. We describe 2 patients who developed spontaneous painful leg ulcers during long-term hydroxyurea therapy for a myeloproliferative disorder; these ulcers healed only after hydroxyurea was withdrawn.
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PMID:Leg ulcers associated with long-term hydroxyurea therapy. 970 57

The unusual appearance of extensive skin ulcerations has been reported in patients with chronic myelogenous leukemia (CML) undergoing continuous chemotherapy with hydroxyurea. It is thought that hydroxyurea, an antineoplastic agent with selective cytotoxicity for cells that divide most actively (such as those of the skin), causes these ulcerations through impairment of normal wound healing in areas of common trauma. The most common site of ulcers is the leg, where the ulcers are often extremely painful, with violaceous macules surrounding them, and are associated with extensive edema. On biopsy, histological vascular changes include leukocytoclastic vasculitis, perivascular lymphocytic infiltration, formation of thrombus, swelling of the endothelial cells, and thickening of the vascular walls. We report successful split-thickness skin grafting on hydroxyurea-related leg ulcers after preoperative discontinuation of hydroxyurea treatment in a patient with CML. The possible pathogenesis of hydroxyurea-related leg ulcers is discussed.
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PMID:Hydroxyurea-related leg ulcers in a patient with chronic myelogenous leukemia: a case report and review of the literature. 1006 14

Hydroxyurea is a common cancer chemotherapy agent that inhibits ribonucleotide reductase, an enzyme essential to DNA synthesis. It is considered the drug of choice in the treatment of chronic myelogenous leukemia and essential thrombocythemia. The occurrence of leg ulcers have been described in 8.5% of patients receiving continuous treatment with hydroxyurea, but the cause of this complication is unknown. We report two additional patients and suggest that macroerythrocytosis, which occurs in almost all the patients taking hydroxyurea, may be a pathogenic factor. Macroerythrocytosis can be considered as an 'acquired' blood dyscrasia, and similar leg ulcers have long been known to occur with certain hereditary blood dyscrasias, such as sickle cell anemia, thalasemia, and spherocytosis.
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PMID:Hydroxyurea-induced leg ulcers: is macroerythrocytosis a pathogenic factor? 1046 46

Unless they undergo transplantation, all patients with chronic myeloid leukemia (CML) will eventually develop a late phase of acute blast crisis (ABC). Although additional chromosomal abnormalities to the Philadelphia (Ph) chromosome may herald ABC in many CML cases, the mechanisms leading to this fatal event are obscure. Viral etiology, including the Epstein-Barr virus (EBV) has never been implicated in the pathogenesis of ABC in CML. Iloprost is an analogue of epoprostenol (prostacyclin; PGI2) commonly used for the treatment of peripheral vascular diseases and acts via inhibition of platelet activation, and by vasodilation. A case of ABC with blasts of undetermined lineage showing EBV infection in a male patient with Ph positive CML is described here. This unusual event developed during a course of treatment with the prostacyclin analogue, iloprost administered for vasculopathic leg ulcers. The proliferating blasts stained positively by immunohistochemistry only for the leukocyte common antigen (LCA/CD-45), and the EBV-latent membrane protein 1 (LMP-1). The only chromosomal abnormality detected by cytogenetic analysis was the conventional Ph-chromosome. It is suggested that ABC in this case of CML, was associated with EBV-activated blasts of undetermined lineage.
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PMID:Acute blast crisis with EBV-infected blasts, in a patient with chronic myeloid leukemia, and vasculitis. 1075 95

A 34 years non diabetic lady with chronic myeloid leukaemia (CML) was treated with hydroxyurea and interferon. She developed leg ulcers. First time on left toe and three months later on right foot, a rare complication of hydroxyurea. Both were treated with local wound care and antibiotics. First time dose of hydroxyurea was reduced and second time drug was discontinued.
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PMID:Hydroxyurea induced leg ulcers. 1119 98

The cutaneous side effects of hydroxyurea are lesser known complication of long term hydroxyurea therapy in myeloproliferative disorders. We report a non-diabetic patient, who developed hydroxyurea dermopathy (leg ulcers) during long-term treatment with hydroxyurea for chronic myeloid leukemia (CML). The time course of the development of ulcers and its healing suggests that these resulted from the direct toxicity of hydroxyurea. We aim to increase clinical awareness of this problem.
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PMID:Reversible leg ulcer due to hydroxyurea in a case of chronic myeloid leukemia. 1471 96

Hydroxyurea is commonly used in the treatment of various myeloproliferative disorders. In conventional pediatric clinical practice, its use is limited to benign hematologic conditions such as sickle cell disease and thalassemia. Long-term hydroxyurea use is associated with various adverse mucocutaneous effects including hyperpigmentation, alopecia, leg ulcers, and lichenoid eruptions. We report a 10-year-old boy with chronic myelogenous leukemia who presented with hyperpigmentation of the skin and nails 3 months after the start of hydroxyurea therapy. Melanonychia of all 20 nails with involvement of all three mucocutaneous areas (skin, nails, and mucosa) at presentation was a unique feature in our patient. With the recently increasing pediatric use of hydroxyurea in a variety of disorders, its benign and not so uncommon cutaneous adverse effects are emphasized here.
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PMID:Cutaneous manifestations of hydroxyurea therapy in childhood: case report and review. 1507 51


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