AML-030: The Diagnostic Yield and Safety of Skin Biopsies in Patients with Acute Myeloid Leukemia During Intensive Chemotherapy - A Retrospective Cohort Study

Abstract

Context Skin eruptions are common in acute myeloid leukemia (AML). However, data on the safety and diagnostic yield of skin biopsies in affected patients are scarce. Objective To evaluate the yield and safety of skin biopsies obtained from adult patients with AML during hospitalization for intensive chemotherapy. Methods The database of a tertiary university-affiliated medical center was retrospectively searched for patients with AML who underwent biopsies for skin eruptions during hospitalization in 2007-2018. Clinical, laboratory, and outcome data were collected. Results Of 216 consecutive patients diagnosed with AML, we identified 35 patients who underwent 37 skin biopsies: 22% at presentation and the remainder after chemotherapy commencement. Histopathological diagnoses were drug eruption (24.3%), infection (11%), leukemia cutis (16.2%), Sweet syndrome (5.5%), and a reactive process (8%); in 35% of biopsies, findings were inconclusive. Tissue cultures, performed in 16 patients, were positive in 4 (25%). Only in 8% of cases did the biopsy results lead to a change in management. One patient had bleeding and fever as a result of the biopsy. Conclusions Our study suggests that skin biopsies are relatively safe to perform in patients with AML undergoing intensive chemotherapy, although their diagnostic yield is limited.