Secondary Skin Cancer in a Case with Long-term Voriconazole after Allogeneic Hematopoietic Stem Cell Transplantation for Acute Myeloid Leukemia

Noriaki Kawano; Shunou Nakamura; Kousuke Mochida; Shuro Yoshida; Takuro Kuriyama; Takashi Nakaike; Tomonori Shimokawa; Taro Tochigi; Kiyoshi Yamashita; Koichi Mashiba; Ikuo Kikuchi; Aina Takarabe; Sayaka Moriguchi; Yasuo Mori; Katsuto Takenaka; Kazuya Shimoda; Hidenobu Ochiai; Masahiro Amano

doi:10.2169/internalmedicine.8618-21

Secondary Skin Cancer in a Case with Long-term Voriconazole after Allogeneic Hematopoietic Stem Cell Transplantation for Acute Myeloid Leukemia

Intern Med. 2022 Sep 15;61(18):2771-2774. doi: 10.2169/internalmedicine.8618-21. Epub 2022 Jan 13.

Authors

Noriaki Kawano¹, Shunou Nakamura², Kousuke Mochida², Shuro Yoshida¹, Takuro Kuriyama¹, Takashi Nakaike¹, Tomonori Shimokawa¹, Taro Tochigi¹, Kiyoshi Yamashita¹, Koichi Mashiba¹, Ikuo Kikuchi¹, Aina Takarabe³, Sayaka Moriguchi⁴, Yasuo Mori⁵, Katsuto Takenaka⁶, Kazuya Shimoda⁷, Hidenobu Ochiai⁸, Masahiro Amano²

Affiliations

¹ Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan.
² Department of Dermatology, Faculty of Medicine, University of Miyazaki, Japan.
³ Department of Dermatology, Miyazaki Prefectural Miyazaki Hospital, Japan.
⁴ Department of Pathology, Miyazaki Prefectural Miyazaki Hospital, Japan.
⁵ Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Japan.
⁶ Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine, Japan.
⁷ Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Japan.
⁸ Trauma and Critical Care Center, Faculty of Medicine, University of Miyazaki, Japan.

Abstract

Secondary malignancies that develop after allogeneic-hematopoietic stem cell transplantation (allo-HSCT) have become serious issues. A 47-year-old man who developed acute myeloid leukemia in 2009 and subsequently underwent allo-HSCT twice: in 2009 and 2011. In 2015, voriconazole for lung aspergillus was started. In 2018, chronic graft-versus-host disease (GVHD) and multiple actinic keratoses manifested at his head. In 2020, some lesions were diagnosed as squamous cell carcinoma, so voriconazole was withdrawn, and subsequent surgery and radiation led to remission. Long-term administration of voriconazole in addition to allo-HSCT and chronic GVHD may be closely related to secondary skin cancer.

Keywords: allo-HSCT; chronic GVHD; secondary skin cancer; voriconazole.

Publication types

Case Reports

MeSH terms

Graft vs Host Disease* / drug therapy
Graft vs Host Disease* / etiology
Hematopoietic Stem Cell Transplantation* / adverse effects
Humans
Leukemia, Myeloid, Acute* / pathology
Leukemia, Myeloid, Acute* / therapy
Male
Middle Aged
Retrospective Studies
Skin Neoplasms* / etiology
Transplantation, Homologous / adverse effects
Voriconazole / therapeutic use

Substances

Voriconazole