Markers of systemic involvement and death in hospitalized cancer patients with severe cutaneous adverse reactions Journal Article

   


Authors: Mori, S.; Hickey, A.; Dusza, S. W.; Lacouture, M. E.; Markova, A.
Article Title: Markers of systemic involvement and death in hospitalized cancer patients with severe cutaneous adverse reactions
Abstract: Background: Severe cutaneous adverse reactions (SCARs) are frequent in inpatient oncology. Early intervention might reduce morbidity, mortality, and hospitalization costs; however, current clinical and histologic features are unreliable SCAR predictors. There is a need to identify rational markers of SCARs that could lead to effective therapeutic interventions. Objective: To characterize the clinical and serologic features of hospitalized patients with cancer who developed SCARs. Methods: Retrospective review of 49 hospitalized cancer patients with a morbilliform rash, recorded testing for serum cytokines (interleukin [IL] 6, IL-10, and tumor necrosis factor [TNF] α) or elafin, and a prior dermatology consultation. Patients were categorized as having a simple morbilliform rash without systemic involvement or complex morbilliform rash with systemic involvement. Results: Fifteen out of 49 patients (30.6%) were deceased at 6 months from time of dermatologic consultation. Elafin, IL-6, and TNF-α were significantly higher in patients who died compared with patients who were still alive at 6 months. IL-6 and IL-10 were significantly higher in patients with a drug-related complex rash. Limitations: Retrospective design, limited sample size, and high-risk patient population. Conclusion: In cancer patients with SCARs, elafin, IL-6, and TNF-α levels might predict a poor outcome. Agents directed against these targets might represent rational treatments for the prevention of fatal SCARs. © 2018 American Academy of Dermatology, Inc.
Keywords: clinical article; controlled study; clinical feature; disease marker; cancer patient; protein blood level; melanoma; ovary cancer; breast cancer; interleukin 10; cohort analysis; medical record review; retrospective study; prostate cancer; sarcoma; bilirubin; cutaneous t cell lymphoma; cytokine; acute graft versus host disease; hematologic malignancy; colon cancer; interleukin 6; hospital patient; consultation; urogenital tract tumor; kidney cancer; bilirubin blood level; serology; tumor necrosis factor; measles like rash; adverse event; cancer prognosis; drug reaction; human; male; female; priority journal; article; graft versus host disease; all cause mortality; drug rash; drug reaction with eosinophilia and systemic symptoms; drug-induced hypersensitivity syndrome; severe cutaneous adverse reaction; tiprelestat
Journal Title: Journal of the American Academy of Dermatology
Volume: 80
Issue: 3
ISSN: 0190-9622
Publisher: Mosby Elsevier  
Date Published: 2019-03-01
Start Page: 608
End Page: 616
Language: English
DOI: 10.1016/j.jaad.2018.10.039
PUBMED: 30612984
PROVIDER: scopus
PMCID: PMC6372330
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85059768945&doi=10.1016%2fj.jaad.2018.10.039&partnerID=40&md5=e4155f7705152d596cb3188dee6e657c
Notes: Article -- Export Date: 1 March 2019 -- Source: Scopus
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MSK Authors
  1. Mario E Lacouture
    457 Lacouture
  2. Stephen Dusza
    289 Dusza
  3. Alina Markova
    87 Markova
  4. Shoko Mori-DeMarco
    16 Mori-DeMarco
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