[Refractory acute monocytic leukemia with cutaneous infiltration complicated by sterile pustules after CPX-351 administration].

Abstract

CPX-351 (Vyxeos^®), a liposomal formulation used in the treatment of acute myeloid leukemia, has been associated with cutaneous adverse events, particularly purpura, in previous clinical trials. We present the case of a 73-year-old woman with refractory acute monocytic leukemia and leukemia cutis, who was treated with CPX-351 as salvage induction therapy. Following treatment, the extramedullary lesions resolved; however, some skin lesions developed into pustular eruptions. These pustules appeared during the neutropenic phase, and cultures ruled out infection, leading to the diagnosis of sterile pustulosis. Supportive care, including skin care measures and application of antibiotic ointment, allowed for continued treatment, and the pustules resolved after crusting. To our knowledge, this is the first reported case of sterile pustulosis associated with CPX-351 treatment, highlighting the importance of early detection and appropriate management of skin complications for the successful continuation of therapy.