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Oral bexarotene for post‐transplant cutaneous T‐cell lymphoma
Author(s) -
Lewis Daniel J.,
Huang Simo,
Duvic Madeleine
Publication year - 2017
Publication title -
dermatologic therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.595
H-Index - 68
eISSN - 1529-8019
pISSN - 1396-0296
DOI - 10.1111/dth.12524
Subject(s) - bexarotene , medicine , mycosis fungoides , immunosuppression , lymphoma , tacrolimus , dermatology , cutaneous t cell lymphoma , refractory (planetary science) , peripheral t cell lymphoma , transplantation , t cell lymphoma , gastroenterology , t cell , immunology , immune system , biochemistry , chemistry , physics , nuclear receptor , astrobiology , transcription factor , gene
Organ transplant recipients receiving immunosuppression have an increased risk of developing post‐transplant lymphoproliferative diseases (PTLDs). Traditionally, PTLDs refer to Epstein‐Barr virus (EBV)‐induced B‐cell lymphoma. However, post‐transplant T‐cell lymphoma may also occur and tends to have a poorer response to reduced immunosuppressive therapy. As such, additional therapy is often needed for post‐transplant T‐cell lymphoma, including post‐transplant cutaneous T‐cell lymphoma (PT‐CTCL). We present only the third case of PT‐CTCL occurring after liver transplantation. The patient was diagnosed with stage IB mycosis fungoides (MF). His lesions were refractory to multiple skin‐directed therapies, and so he was given oral bexarotene 150 mg daily and his oral tacrolimus dose was decreased to 2 mg daily. Remarkably, his MF patches have demonstrated a complete response to oral bexarotene 75 mg daily without recurrence over 11 years of follow‐up. He developed hypertriglyceridemia with bexarotene 150 mg, so his dose was decreased to 75 mg, without loss of response. Our report is the second to describe PT‐CTCL demonstrating a long‐term complete response to oral bexarotene. Given its anti‐carcinogenic properties and favorable toxicity profile, oral bexarotene represents an appealing treatment option for PT‐CTCL refractory to skin‐directed therapies.