Primary Cutaneous CD30+/ALK- ALCL with Transition into sALCL: Favourable Response after Systemic Administration with Brentuximab Vedotin! Unique Presentation in a Bulgarian Patient!
Keywords:Anaplastic large, T cell lymphoma, Brentuximab, Remission, CD30
BACKGROUND: Modern drugs could sometimes be a good solution even to problematic patients. The cutaneous and systemic forms of the CD30 positive anaplastic large T-cell lymphoma could often be described as a suitable target for therapy with Brentuximab vedotin.
CASE REPORT: We present the first case of a Bulgarian patient with a histologically confirmed primary cutaneous T-cell CD30+/ALK- large anaplastic cell lymphoma-cALCL (therapeutically resistant to therapy with Methotrexate, radiation therapy and systemic corticosteroid therapy) who was successfully treated with Brentuximab vedotin. In several years, the patient has developed a comparatively fast skin progression as well as an initial systemic one which impacts inguinal and mediastinal nodes. After the implementation of 4 therapy cycles with Brentuximab vedotin, complete regression of the described by previous hospitalisations lymph nodes as well as 80% reduction of the cutaneous and subcutaneous located tumour formations were observed.CONCLUSION: The therapy of CD30+/ALK- anaplastic large T-cell lymphoma is a significant challenge for oncologists and dermatologists because it requires maximally efficient and minimally traumatic treatment in parallel. Therapy with Brentuximab is a new direction which shows extremely good clinical results and can be applied to the cutaneous as well as to the systemic form of anaplastic large-cell CD30 positive lymphoma. The key element by treatment with Brentuximab is suppression of the CD30- expression which, in turn, could be the cause of relapses. On that ground, patients with these lymphomas should be strictly monitored.
Plum Analytics Artifact Widget Block
Prince HM, Kim YH, Horwitz SM, Dummer R, Scarisbrick J, Quaglino P, Zinzani PL, Wolter P, Sanches JA, Ortiz-Romero PL, Akilov OE. Brentuximab vedotin or physician's choice in CD30-positive cutaneous T-cell lymphoma (ALCANZA): an international, open-label, randomised, phase 3, multicentre trial. The Lancet. 2017; 390(10094):555-66. https://doi.org/10.1016/S0140-6736(17)31266-7
Xing X, Feldman AL. Anaplastic large cell lymphomas: ALK positive, ALK negative, and primary cutaneous. Advances in anatomic pathology. 2015; 22(1):29-49. https://doi.org/10.1097/PAP.0000000000000047 PMid:25461779
Koh Y. Extended use of brentuximab vedotin before autologous stemâ€cell transplantation would benefit refractory systemic anaplastic largeâ€cell lymphoma. Clinical case reports. 2018; 6(5):798-801. https://doi.org/10.1002/ccr3.1461 PMid:29744059 PMCid:PMC5930222
Aguiar-Bujanda D, Due-as-Comino A, Cabello C, Bastida J, Rivero-Vera JC, Limeres-GonzÃ¡lez MA. Early and sustained remission with brentuximab vedotin in a case of disseminated cutaneous relapse from systemic anaplastic large cell lymphoma refractory to chemotherapy. European Journal of Dermatology. 2017; 27(6):671-3. PMid:29165301
Oregel KZ, Everett E, Zhang X, Nagaraj G. Complete response in a critically ill patient with ALK-negative anaplastic large cell lymphoma treated with single agent brentuximab-vedotin. Expert review of anticancer therapy. 2016; 16(3):279-83. https://doi.org/10.1586/14737140.2016.1146597 PMid:26809026
Colton Nielson BS, Ryan Fischer MD, Garth Fraga MD. Loss of CD30 expression in anaplastic large cell lymphoma following brentuximab therapy. J Drugs Dermatol. 2016; 15(7):894-5. PMid:27391642
How to Cite
All rights reserved.