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December 1991

Cutaneous Reactions to Azacitidine

Author Affiliations

Department of Dermatology

Department of Hematology/Oncology Bowman Gray School of Medicine of Wake Forest University Medical Center Boulevard Winston-Salem, NC 27157-1071

Arch Dermatol. 1991;127(12):1847-1848. doi:10.1001/archderm.1991.04520010089020

To the Editor.  —5-Azacitidine is a pyrimidine analog that has demonstrated activity as an antileukemic agent and as a treatment for some hemoglobinopathies.1 It has been investigated as a treatment modality for myelodysplastic syndromes (Cancer and Leukemia Group B [CALG B] Protocol 8921: A Phase II Study of 5-Azacitidine in Myelodysplastic Syndromes). In previous studies, no cutaneous complicationshave been reported from the subcutaneous administration of 5-azacitidine.2We describe two patients with myelodysplastic syndromes in whom reproducible cutaneous reactions developed at injection sites of subcutaneous 5-azacitidine.

Report of Cases.  —Case 1.—A 45-year-old white man was hospitalized for treatment of refractory anemia with excess blast forms in transformation. Chemotherapy had been started with 5-azacitidine given at a dose of 180 mg/d divided into two subcutaneous injection sites for a scheduled 7-day course. No other chemotherapy was being administered. On the third day of treatment, it was noted that the

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