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Radiation therapy for leukemia cutis.

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Leukemia cutis (LC) treatment with radiation therapy (RT) shows limited long-term control, especially when marrow disease is active. Total skin electron beam therapy is recommended for diffuse LC with marrow remission, while focal therapy is for palliation.

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Area of Science:

  • Oncology
  • Dermatology
  • Radiation Oncology

Background:

  • Leukemia cutis (LC) involves neoplastic leukocyte infiltration of the skin, often presenting as cutaneous lesions.
  • Electron-based radiation therapy (RT) is a common treatment for LC, but recent data are scarce.
  • This study evaluates RT response, disease control, and toxicity in LC patients.

Purpose of the Study:

  • To analyze treatment response, disease control, and toxicity of RT for leukemia cutis.
  • To develop evidence-based treatment recommendations for LC patients receiving RT.

Main Methods:

  • Retrospective review of 15 patients with LC treated between November 1994 and August 2009.
  • Analysis of treatment outcomes for patients receiving total skin electron beam (TSEB) therapy versus focal RT.
  • Evaluation of response rates, local control, survival, and toxicity.

Main Results:

  • LC occurred a median of 2 months after acute myeloid leukemia diagnosis.
  • Total skin electron beam therapy (TSEB) achieved an 89% response rate in diffuse LC with marrow remission.
  • One-year local control was 33%, and skin relapse correlated with active or recurrent marrow disease.
  • RT was generally well-tolerated, with limited acute toxicity.

Conclusions:

  • Leukemia cutis is an aggressive manifestation of leukemia with poor long-term survival.
  • Total skin electron beam therapy (TSEB) is indicated for diffuse LC in patients with marrow remission.
  • Focal electron therapy should be reserved for palliation; systemic disease control is crucial for durable remission.