Vasculitis and leukemia

Vasculitis may accompany neoplasias and be of paraneoplastic type or associ ated with drugs used in patient treatment. We evaluated skin biopsies of tw enty-eight cases with vasculitis accompanying leukemias reviewed and clinic al outcome was evaluated. Eleven of the 28 cases had paraneoplastic vasculi tis and 17 had vasculitis associated with various drugs including chemother apy, cytokines and antibacterial agents. Paraneoplastic vasculitis was seen in 3 cases with chronic myelocytic leukemia in blastic phase, 5 patients w ith acute myeloblastic leukemia, and 3 with myelodysplastic syndrome. Drugs responsible for the 17 cases of vasculitis included hydroxyurea, vincristi ne, cytosine-arabinoside, methotrexate, all-trans retinoic acid, granulocyt e-colony stimulating factor, interferon and antibiotics. Paraneoplastic vasculitis is not rare in leukemias and may be a manifestati on of the blastic phase of chronic myeloid leukemia. Furthermore paraneopla stic vasculitis can be fatal in myelodysplastic syndromes and may be presen t clinically before the specific diagnosis is made. Drugs used in routine t herapy may be the cause of the vasculitis, thus skin biopsy should be perfo rmed in all cutaneous lesions in patients with hemopoietic neoplasias.