Drug-induced skin reactions in patients with acute non-lymphocytic leukaemia

The incidence of drug-induced skin rashes and related factors were analysed in a retrospective study of 151 patients with acute non-lymphocytic leukaemia (ANLL). 91 (60%) developed a drug-related toxicodermia to one or more drugs during remission, induction and maintenance therapy. The incidence of rashes was mainly confined to the blastic stage of leukaemia and occurred significantly less often during remission. Patients with acute myeloid leukaemia, FAB classification M1, M2 and M3 (M1-3) developed skin reactions more often than those of types M4 and M5 (M4-5). Women suffered more frequently from drug-induced skin lesions than men. The incidence of drug-associated rashes was significantly higher in patients with ANLL than in the general population for: Allopurinol (16%), co-trimoxazole (14%), miconazole (28%), and ketoconazole (18%). The incidence for the penicillins (12%) and cephalosporins (3%) conformed to the upper limit as reported for the general population. Additional toxic effects of combined therapy could not explain the differences observed and a dearrangement of the immunesystem during the blastic stage of leukaemia is suggested.