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Cohort Study of CLL and Leukemia Cutis From the French Innovative Leukemia Organization

By: Lauren Harrison, MS
Posted: Wednesday, July 28, 2021

The presence of leukemia cutis among a cohort of patients with chronic lymphocytic leukemia (CLL) did not appear to have an impact on prognosis, and no specific clinical or biologic profile was found to be associated with leukemia cutis, according to a large cohort study from the French Innovative Leukemia Organization. Leukemia cutis is the cutaneous infiltration of neoplastic B lymphocytes and is uncommonly seen in CLL. This study was published by Florence Cymbalista, MD, PhD, of the Université Paris Sorbonne Nord, Bobigny, France, and colleagues in the American Journal of Hematology.

Researchers retrospectively analyzed a cohort of 46 patients with CLL and leukemia cutis, representing reportedly the largest studied cohort of patients with these two disease processes to date. Patient blood samples were assessed using fluorescence in situ hybridization, karyotyping, and next-generation sequencing. Patients in this cohort had diffuse (n = 16), localized (n =13), or regional (n = 9) skin lesions, with the head and neck being the most common sites of leukemia cutis. These lesions were typically popular and/or nodular (n = 24) or patches (n = 9).

Karyotype analysis was performed in 32 patients; 7 patients had normal karyotypes, and 6 had more than 3 abnormalities. There was a high frequency of t(14;18) translocations (18.5% of patients). Peripheral blood mutational profiles were available for 40 patients; 15 (37%) had no mutations, 15 (15%) had a single mutation, and 10 (25%) had 2 to 5 mutations. Commonly mutated genes among this group included NOTCH1 (22.5%), TP53 (20%), SF3B1 (12.5%), and BIRC3 (12.5%).

Follow-up data were available for 32 patients. A majority (62.5%) of patients had skin lesions present before the initiation of first-line treatment, and 31 patients received treatment after the development of skin lesions. Systemic treatment led to a complete skin response in 23 of 31 patients, suggesting a clonal relation between skin lesions and hematologic disease. These data suggest that leukemia cutis may respond well to treatment and does not seem to affect prognosis.

Disclosure: The study authors reported no conflicts of interest.



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