Introduction
Sweet's syndrome (SS) is associated with hematologic malignancies including acute myeloid leukemia (AML).
Methods
Patients with AML treated at our institution were reviewed to identify those with SS. Patient characteristics, laboratory values, and cytogenetic and molecular abnormalities were retrospectively reviewed.
Results
We identified 21 out of 2,178 (1%) AML patients that demonstrated clinical signs and symptoms, and histological features consistent with SS. Eleven patients (52%) were classified as AML with myelodysplasia-related features while three patients had therapy-related AML. Three patients had received treatment with granulocyte colony stimulation factor, one patient liposomal all-trans retinoic acid and two patients received hypomethylating agents prior to development of SS. Cytogenetic analysis revealed diploid karyotype in seven patients (33%), -5/del(5q) in eight patients {38%; three patients had -5/del(5q) as sole abnormality and five patients had -5/del(5q) as part of complex cytogenetics}, and complex cytogenetics in five patients (24%). Gene mutations in fms-related tyrosine kinase-3 (FLT3) gene were identified in seven of 18 evaluable patients (39%), including FLT3 –internal tandem duplication in four patients and FLT3 -D835 tyrosine kinase domain mutation in three patients.
Conclusions
SS occurs in 1% of AML patients; -5/del(5q) karyotype, FLT3 mutations, and AML with myelodysplasia-related features were more frequent among patients with SS.