Dermatologic changes associated with roquinimex immunotherapy after autologous bone marrow transplant.
BACKGROUND
Roquinimex (Linomide) is an immunotherapeutic agent used in conjunction with autologous bone marrow transplantation (ABMT) for treatment of acute and chronic myelogenous leukemia (AML and CML). This agent may induce graft-versus-host reactions (GVHR) as well as graft-versus-leukemia (GVL) effects.


OBJECTIVE
We documented the incidence of acute cutaneous GVHR associated with roquinimex immunotherapy. The presence or absence of autologous GVHR was also correlated with a potential GVL effect in patients with CML treated with ABMT and subsequent roquinimex immunotherapy in the period after the transplant.


METHODS
Fifteen patients undergoing bone marrow transplantation and roquinimex immunotherapy for CML were followed up, and clinicopathologic data were analyzed.


RESULTS
Acute cutaneous GVHRs were observed in 6 of 15 patients (40%) treated with roquinimex. Ten of 11 evaluable patients receiving roquinimex exhibited eccrine sweat gland necrosis (ESGN) (90.9%), which was independent of the acute GVHR. Neither bone marrow engraftment status nor the survival rates of patients with and without GVHR was significantly different.


CONCLUSIONS
Roquinimex immunotherapy enhances the incidence of GVHR and was associated with a high rate of ESGN in patients with CML who were undergoing ABMT. There was no significant association between ESGN and acute GVHR. Acute autologous GVHR caused by roquinimex did not correlate with a GVL effect in our study of 15 patients with CML.
Ohsuga
Y
Y
Department of Dermatology, University of Rochester School of Medicine and Dentistry, NY, USA.
Rowe
J M
JM
Liesveld
J
J
Burns
R P
RP
Gaspari
A A
AA
D000276:Adjuvants, Immunologic / Q000009:adverse effects* / Q000627:therapeutic use; D000328:Adult; D016026:Bone Marrow Transplantation; D005260:Female; D006086:Graft vs Host Disease / Q000139:chemically induced* / Q000209:etiology; D020544:Graft vs Leukemia Effect; D006801:Humans; D006912:Hydroxyquinolines / Q000009:adverse effects* / Q000627:therapeutic use; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy; D008297:Male; D009336:Necrosis; D013543:Sweat Gland Diseases / Q000139:chemically induced* / Q000473:pathology; D014182:Transplantation, Autologous
D000276:Adjuvants, Immunologic; D006912:Hydroxyquinolines; C045282:roquinimex