Adverse Cutaneous Reactions to the New Second-Generation Tyrosine Kinase Inhibitors (Dasatinib, Nilotinib) in Chronic Myeloid Leukemia

    November 2013 in “ Journal of the American Academy of Dermatology ”
    Livia Delgado, Stéphane Giraudier, Nicolás Ortonne, O. Zehou, Catherine Cordonnier, Anne Hulin, Olivier Chosidow, Michel Tulliez, Laurence Valeyrie‐Allanore
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    Studysummary This study observed that 71% of chronic myeloid leukemia patients treated with second-generation tyrosine kinase inhibitors experienced adverse cutaneous reactions, which were generally less severe than those caused by imatinib. Our plain-language summary of this paper — not a Tressless recommendation.
    The study investigated adverse cutaneous reactions (ACRs) in 39 chronic myeloid leukemia (CML) patients treated with second-generation tyrosine kinase inhibitors (TKIs), nilotinib and dasatinib. ACRs were observed in 71.8% (28 patients), including xerosis, edema, pruritus, scalp alopecia, body hair loss, and keratosis pilaris. Most reactions were mild to moderate and managed with topical treatments and antihistamines, though severe reactions led to TKI withdrawal in two cases. The study highlighted a higher prevalence of ACRs than previously reported and suggested a follicular centric process, particularly with keratosis pilaris and alopecia. Despite frequent ACRs, they were generally less severe than those induced by imatinib, and early management could improve patient adherence and quality of life.
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