Sorafenib induced Hand Foot Skin Rash in FLT3 ITD mutated Acute Myeloid leukemia- A case report and review of literature

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Jayastu Senapati
Anup J Devasia
Abhijeet Ganapule
Leni George
Auro Viswabandya *
(*) Corresponding Author:
Auro Viswabandya | aurov@cmcvellore.ac.in

Abstract

Sorafenib is a novel small molecule multiple kinase inhibitor which has been used for metastatic renal cancer, hepatocellular cancer. Sorafenib induced skin rash has been discussed as a side effect in trials in both FLT3 wild type and mutated acute myeloid leukemia (AML) as monotherapy or as combination with other chemotherapeutic agents . We describe a patient with FLT 3 ITD mutated AML who was started on adjunctive Sorafenib therapy. Skin reactions manifested as NCI Grade III palmoplantar erythrodysesthesia (PPE), requiring drug discontinuation. Several pathogenic mechanisms have been implicated in Sorafenib induced skin reactions, but none has been conclusively proven. While treatment options are varied for early stage skin reactions, drug discontinuation remains the only possible therapy presently for severe grade skin reaction.

 


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Author Biographies

Jayastu Senapati, Department of Clinical Haematology, Christian Medical College and Hospital,Vellore

Junior Clinical Assistant

Department of Clinical Haematology,

Christian Medical College and Hospital, Vellore.

Anup J Devasia, Department of Clinical Haematology, Christian Medical College and Hospital Vellore

Senior Registrar,

Department of Clinical Haematology,

Christian Medical College and Hospital, Vellore.

Abhijeet Ganapule, Department of Clinical Haematology, Christian Medical College and Hospital,Vellore

Assistant Professor,

Department of Clinical Haematology,

Christian Medical College and Hospital, Vellore.

 

Leni George, Department of Dermatology, Christian Medical College and Hospital Vellore

Professor,

Department of Dermatology,

Christian Medical College and Hospital Vellore

 

Auro Viswabandya, Department of Clinical Haematology, Christian Medical College and Hospital, Vellore

Professor,

Department of Clinical Haematology,

Christian Medical College and Hospital, Vellore.