Pyoderma gangrenosum-like neutrophilic dermatosis as an adverse effect of menin-KMT2A inhibitor therapy for acute myeloid leukaemia.

Menin-KMT2A inhibitors (MENi) are a novel class of small-molecule inhibitors in development in KMT2Ar and NPM1m acute myeloid leukaemias (AML) and a notorious cause of differentiation syndrome (DS). A 71 years old woman received the MENi revumenib (REV) for relapsed/refractory NPM1m AML. After 2 weeks of treatment, she developed fever and a violaceous inflammatory cutaneous lesion of the right cheek, revealing REV induced pyoderma gangrenosum (PG)-like neutrophilic dermatosis (ND). Isolated reports of all-trans retinoic acid induced DS-related ND have been published. However, to our knowledge, this is the first report ever of MENi induced PG-like ND and cutaneous involvement of DS. This report highlights the fact that ND such as PG, as a manifestation of DS, are a possibly severe adverse effect of MENi.