Evaluation of treatment results in multifocal primary cutaneous anaplastic large cell lymphoma: report of the Dutch Cutaneous Lymphoma Group

Autor: Maarten H. Vermeer, Cornelus J. G. Sanders, Rutger C. Melchers, M.M. van Rossum, J. C. J. M. Veraart, Koen D. Quint, Marcel W. Bekkenk, Barbara Horváth, E.R.M. de Haas, Rein Willemze
Přispěvatelé: Translational Immunology Groningen (TRIGR), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Dermatologie, MUMC+: MA Dermatologie (9), Dermatology, CCA - Cancer Treatment and quality of life, CCA - Cancer Treatment and Quality of Life
Rok vydání: 2018
Předmět:
Male
Skin Neoplasms
medicine.medical_treatment
CHOP
GUIDELINES
Gastroenterology
THERAPY
Cutaneous lymphoma
RECOMMENDATIONS
Cancer development and immune defence Radboud Institute for Health Sciences [Radboudumc 2]
030207 dermatology & venereal diseases
Lymphoma
Primary Cutaneous Anaplastic Large Cell
0302 clinical medicine
Prednisone
Antineoplastic Combined Chemotherapy Protocols
Brentuximab vedotin
Netherlands
Skin
Aged
80 and over
Chemoradiotherapy
Middle Aged
PAPULOSIS
METHOTREXATE
EORTC
Treatment Outcome
Vincristine
030220 oncology & carcinogenesis
CD30-POSITIVE LYMPHOPROLIFERATIVE DISORDERS
Female
medicine.drug
Adult
medicine.medical_specialty
Cyclophosphamide
TNM CLASSIFICATION-SYSTEM
Primary cutaneous anaplastic large cell lymphoma
Dermatology
03 medical and health sciences
BRENTUXIMAB VEDOTIN
Internal medicine
medicine
Humans
Aged
Retrospective Studies
business.industry
medicine.disease
Survival Analysis
Lymphoma
Radiation therapy
Doxorubicin
Neoplasm Recurrence
Local
business
BEXAROTENE
Follow-Up Studies
Zdroj: BRITISH JOURNAL OF DERMATOLOGY, 179(3), 724-731. Wiley
Melchers, R C, Willemze, R, Bekkenk, M W, de Haas, E R M, Horvath, B, van Rossum, M M, Sanders, C J G, Veraart, J C J M, Vermeer, M H & Quint, K D 2018, ' Evaluation of treatment results in multifocal primary cutaneous anaplastic large cell lymphoma: report of the Dutch Cutaneous Lymphoma Group ', British Journal of Dermatology, vol. 179, no. 3, pp. 724-731 . https://doi.org/10.1111/bjd.16501
British Journal of Dermatology, 179(3), 724-731. Wiley
British Journal of Dermatology, 179(3), 724-731. Wiley-Blackwell
British journal of dermatology, 179(3), 724-731. Wiley-Blackwell
British Journal of Dermatology, 179(3), 724-731. Wiley-Blackwell Publishing Ltd
British Journal of Dermatology, 179, 3, pp. 724-731
British Journal of Dermatology, 179, 724-731
None
ISSN: 1365-2133
0007-0963
DOI: 10.1111/bjd.16501
Popis: BackgroundThere is no consensus on the treatment of multifocal primary cutaneous anaplastic large cell lymphoma (C-ALCL). Radiotherapy (RT) and methotrexate (MTX) are the current treatment options, but their efficacy is unknown. Recently, targeted therapies showed promising results in C-ALCL, and may therefore be an attractive first choice of treatment.ObjectivesTo assess the efficacy of conventional treatment strategies for patients with multifocal C-ALCL, and to define which patients may require novel targeted therapies.MethodsIn this multicentre study, treatment was evaluated in patients initially presenting (n = 24) or relapsing with multifocal C-ALCL (n = 17; 23 relapses). Distinction was made between patients with five or less lesions (n = 36) and more than five lesions (n = 11).ResultsTreatments most commonly used were RT (n = 21), systemic chemotherapy (n = 9) and low-dose MTX (n = 7) with complete response rates of 100%, 78% and 43%, respectively, and an overall response rate of 100%, 100% and 57%, respectively. Four patients showed complete spontaneous regression. In total, 16 of 24 patients (67%) first presenting with multifocal C-ALCL relapsed, including all five patients initially treated with CHOP (cyclophosphamide, hydroxydaunorubicin, oncovin and prednisone). Compared with patients presenting with two to five skin lesions, patients presenting with more than five lesions had a higher chance of developing extracutaneous relapse (56% vs. 20%) and more often died of lymphoma (44% vs. 7%).ConclusionsPatients with five or less lesions should be treated with low-dose RT (2 x 4 Gy). Maintenance low-dose MTX (20 mg weekly) is a suitable option in patients with more than five lesions. Targeted therapies may be considered in rare patients who are refractory to MTX or patients developing extracutaneous disease.What's already known about this topic?There is no consensus on the treatment of multifocal primary cutaneous anaplastic large cell lymphoma (C-ALCL). New targeted therapies are evaluated without knowledge of the efficacy of conventional therapies.What does this study add?This study evaluated the efficacy of conventional therapies for multifocal C-ALCL. Radiotherapy and low-dose methotrexate are suitable options in patients with five or less and more than five lesions, respectively. Targeted therapies may be considered in rare patients who are refractory to methotrexate or developing extracutaneous disease.Linked Comment:Kempf. Br J Dermatol 2018; 179:565-566. Respond to this article
Databáze: OpenAIRE
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