INTRODUCTION Sweet syndrome (SS) is well-known to be associated with underlying hematologic malignancies. The incidence and qualities of SS among novel targeted therapies for acute myeloid leukemia (AML) have not yet been described. METHODS Through retrospective review of 19432 patients diagnosed with acute/chronic leukemia or myelodysplastic syndromes/ myeloproliferative neoplasms (MDS+/-MPN) over 28 years, we calculated the incidence of SS in the setting of select hematologic malignancies and described the clinicopathologic characteristics of SS in patients with onset of SS after initiation of novel AML-targeted therapies. RESULTS Overall incidence of SS was 0.36% (95% CI: 0.27% - 0.45%), which was significantly higher among patients with AML (50/5248, 0.94%; 95% CI: 0.71% - 1.25%). Nine AML patients were on 4 classes of novel targeted treatments - IDH1/2 inhibitor alone, FLT3 inhibitor, IDH2 and DOT1L inhibitor, and anti-CD33 therapy. In therapies inducing myeloid blast differentiation, SS occurred at later onset following treatment. CONCLUSIONS In AML patients with fever and unusual skin lesions, physicians may consider SS earlier which may shorten time to diagnosis. Future assessments of SS among patients treated with novel therapies for AML and molecular studies of biopsies may help further explain this dermatologic adverse event with earlier diagnosis and management of neutrophilic dermatoses in these patients.

中文翻译：

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急性髓性白血病患者的急性发热性中性粒细胞性皮肤病（Sweet 综合征）：28 年机构经验。

引言 众所周知，Sweet 综合征 (SS) 与潜在的血液恶性肿瘤有关。急性髓系白血病 (AML) 新型靶向治疗中 SS 的发生率和质量尚未得到描述。方法 通过对 28 年来 19432 名被诊断患有急性/慢性白血病或骨髓增生异常综合征/骨髓增生性肿瘤 (MDS+/-MPN) 的患者进行回顾性分析，我们计算了特定血液系统恶性肿瘤中 SS 的发生率，并描述了 SS 的临床病理特征。开始新的 AML 靶向治疗后出现 SS 的患者。结果 SS 的总体发生率为 0.36%（95% CI：0.27% - 0.45%），在 AML 患者中显着较高（50/5248，0.94%；95% CI：0.71% - 1.25%）。9 名 AML 患者接受了 4 类新型靶向治疗：单独 IDH1/2 抑制剂、FLT3 抑制剂、IDH2 和 DOT1L 抑制剂以及抗 CD33 治疗。在诱导髓系母细胞分化的治疗中，SS 发生在治疗后较晚的时期。结论 对于有发热和异常皮肤病变的 AML 患者，医生可以更早考虑 SS，这可能会缩短诊断时间。未来对接受 AML 新疗法治疗的患者进行 SS 评估和活检分子研究可能有助于通过早期诊断和治疗这些患者的中性粒细胞性皮肤病来进一步解释这种皮肤病不良事件。