Efficacy of Vinblastine in Primary Cutaneous Anaplastic Large Cell Lymphoma

Efficacy of Vinblastine in Primary Cutaneous Anaplastic Large Cell Lymphoma Primary cutaneous anaplastic large cell lymphoma (C-ALCL) is a rare primary cutaneous CD30+ T-cell lymphoproliferative disorder that affects patients at a median age of 60 years. The disease presents as localized or less frequently disseminated nodules, plaques, or ulcers that mostly affect limbs. Prognosis is favorable (5-year overall survival, >80%). According to the consensus recommendations,1 surgical excision or radiotherapy is recommended for localized lesions. For multifocal lesions, low-dose methotrexate is commonly used with a favorable response.2 Multiagent chemotherapy, such as cyclophosphamide, doxorubicin, vincristine, and prednisone, is effective but because of adverse effects and a high rate of relapses is reserved for disseminated relapse and extracutaneous dissemination.1 Brentuximab vedotin has excellent effectiveness,3 but its use remains off label, expensive, and sometimes responsible for neuropathy and severe infectious complications. Consequently, therapeutic recommendations are lacking for patients with methotrexate failure, especially for older patients. We report a series of 7 patients who received vinblastine as single-agent chemotherapy for relapsing multifocal C-ALCL.