Mucous Membrane Pemphigoid during CPX-351 Therapy Successfully Treated with Corticosteroids.
Masahiro Akimoto, Takashi Matsuki, Michiki Saito et al.
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Case in brief
A 58-year-old man with acute myeloid leukemia with myelodysplasia-related changes achieved complete remission after CPX-351 induction and received a second consolidation course. Soon afterward, progressive aphthous ulcers developed on his tongue. Tongue biopsy was nonspecific, but serum anti-bullous pemphigoid 180 antibodies were positive, supporting a diagnosis of mucous membrane pemphigoid. Corticosteroid therapy produced rapid improvement. The authors considered CPX-351 a likely cause based on the timing of onset.
What made this case unusual
Mucous membrane pemphigoid presented as progressive tongue ulcers during CPX-351 therapy, despite a biopsy without specific findings; serum anti-bullous pemphigoid 180 antibodies supported the diagnosis.
Diagnostic / clinical pearl
When progressive oral ulcers arise during CPX-351 therapy, a nonspecific biopsy does not exclude mucous membrane pemphigoid; serum anti-bullous pemphigoid 180 antibodies may support diagnosis.