Skin Tumors and Reactions to Cancer Therapy in Children by Jennifer T. Huang & Carrie C. Coughlin

Author:Jennifer T. Huang & Carrie C. Coughlin
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Cladribine

Cladribine is used in the treatment of pediatric acute myeloid leukemia (AML) as well as histiocytic disorders like Langerhans cell histiocytosis and systemic mastocytosis. It is a purine analogue that inhibits adenosine deaminase, thereby decreasing purine DNA synthesis. It selectively targets lymphocytes and thus leads to immune suppression.

More common cutaneous side effects noted with cladribine include pruritus and erythematous macules, papules, and plaques that can ulcerate, crust, vesiculate, or become purpuric [36–38]. There is a report of toxic epidermal necrolysis (TEN) occurring after cladribine administration [39]. Onset of side effects is within 2 weeks to 2 months after initiation of medication or after subsequent cycles. Pathology reveals a perivascular dermatitis with lymphocytes, degranulated eosinophils (flame figures), collagen necrobiosis, or intra/subepidermal vesicle formation [38]. Peripheral eosinophilia may occur as well [40–44]. Other less common cutaneous side effects of cladribine include one case of TA-GVHD [45] as well as skin necrosis due to extravasation injury [46].

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