title: Fludarabine Treatment of Patient with Chronic Lymphocytic Leukemia Induces a Digital Ischemia.
abstract: We report a 63-year-old man with a history of chronic lymphocytic leukemia (CLL) who presented with asymmetrical Raynaud's phenomenon of sudden onset which progressed to acral gangrene rapidly in a week. These symptoms began approximately one week after the fourth cycle of fludarabine and cyclophosphamide chemotherapy and were accompanied by pain, numbness, and cyanosis in the fingers of his right hand except the first finger. Fludarabine may play a role in acral vascular syndrome. The treatment with fludarabine in patients with evolving digital ischemia should be carried out with caution.
authors.affiliation: Tepecik Education and Research Hospital, Internal Medicine Clinic, Izmir, Turkey.
authors.forename: Utku Erdem
authors.initials: UE
authors.lastname: Soyaltin
authors.affiliation: Tepecik Education and Research Hospital, Internal Medicine Clinic, Izmir, Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Yuce Yildirim
authors.affiliation: Tepecik Education and Research Hospital, Internal Medicine Clinic, Izmir, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yildirim
authors.affiliation: Tepecik Education and Research Hospital, Internal Medicine Clinic, Izmir, Turkey.
authors.forename: Mehmet Can
authors.identifier: 0000-0002-5600-3169
authors.initials: MC
authors.lastname: Ugur
authors.affiliation: Dortyol Public Hospital, Hatay, Turkey.
authors.forename: Ferhat
authors.identifier: 0000-0002-9317-942X
authors.initials: F
authors.lastname: Ekinci
authors.affiliation: Tepecik Education and Research Hospital, Hematology, Izmir, Turkey.
authors.forename: Cengiz
authors.initials: C
authors.lastname: Ceylan
authors.affiliation: Tepecik Education and Research Hospital, Internal Medicine Clinic, Izmir, Turkey.
authors.forename: Harun
authors.initials: H
authors.lastname: Akar