Alemtuzumab in refractory Sézary syndrome

Abstract

Sézary syndrome is a primary cutaneous T-cell lymphoma characterized by the triad of erythroderma, lymphadenopathy and circulating atypical cells. The emergence of new molecular targets has enabled the development of drugs such as alemtuzumab, an anti-CD52 monoclonal antibody, which has shown promising results in the treatment of this entity. We report the case of a 70-year-old male with refractory Sézary syndrome in whom treatment with alemtuzumab achieved an 80% skin lesion clearance with complete haematologic and radiologic response. The treatment was discontinued after 4 months due to adverse effects, with the patient showing a sustained response without disease progression after 13 months of follow-up.

Adverse Reactions of Antibody-Therapy for Primary Cutaneous Lymphomas: Rituximab, Brentuximab Vedotin, Alemtuzumab, and Mogamulizumab

“…Currently, alemtuzumab is only approved for relapsing remitting multiple sclerosis (MS) [67,68] . Additionally, there is increasing evidence of its efficacy in the therapy for selected cases of cutaneous T-cell lymphoma, such as SS [69][70][71] . The suggested mode of action is antibody-dependent cellular lysis of cells bound to alemtuzumab, however, the exact mechanisms underlying its proposed potential to induce longterm remission for SS but not other cutaneous T-cell lymphomas are yet to be defined [1,[72][73][74][75][76] .…”

“…Nevertheless, some cases with severe infections have been described [1,70,77] . Other adverse events reported in patients with advanced pCTLs included acute coronary syndrome, ischemic colitis, deep-vein thrombosis, and serumsickness-like reaction [70,71,79,80] .…”

“…Occurrence of pancytopaenia has been reported to be dose-dependent. Therefore, close monitoring of complete blood count should be ensured during and after alemtuzumab treatment [66,67,[69][70][71][72]77] .…”