Denileukin Diftitox for the Treatment of Panniculitic Lymphoma

McGinnis, Karen S.; Shapiro, Michael B.; Junkins‐Hopkins, Jacqueline M.; Smith, Mitchell R.; Lessin, Stuart R.; Vittorio, Carmela C.; Rook, Alain H.

doi:10.1001/archderm.138.6.740

Cited by 22 publications

(14 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Case reports describe durable responses with denileukin diftitox in cases of SPTL-AB. 19,20,21 Interferon-α is also reported to be active in refractory SPTL-AB. 18 …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Bexarotene Is Active Against Subcutaneous Panniculitis-Like T-Cell Lymphoma in Adult and Pediatric Populations

Mehta

Wayne

Kim

et al. 2012

Clinical Lymphoma Myeloma and Leukemia

View full text Add to dashboard Cite

Subcutaneous panniculitis-like T-cell lymphoma (SPTL-AB) and cutaneous gamma/delta T-cell lymphoma (CGD-TCL) are rare cutaneous T-cell lymphomas for which no standard treatment exists. We report our experience with bexarotene, an oral retinoid, in 15 adults and children with these disorders. In this series, we found a 77% overall response rate of bexarotene with limited toxicity for these disorders. Introduction Subcutaneous panniculitis-like T-cell lymphoma (SPTL-AB) and cutaneous gamma/delta T-cell lymphoma (CGD-TCL) are rare T-cell lymphomas with varying clinical courses. There is no standard treatment, although chemotherapy and hematopoietic stem cell transplantation are commonly used. We describe results using bexarotene for children and adults with these disorders. Methods We identified 15 patients (12 adults, 3 children) who were treated with bexarotene between 2000 and 2010 from the Memorial Sloan-Kettering Cancer Center lymphoma database, the Stanford Cancer Center Registry, and the National Cancer Institute (NCI) pediatric lymphoma database. There were 8 females and 7 males, with a median age of 45 years (range, 3 years to 85 years). All patients had stage IV disease. Two of 15 and 4 of 15 patients had documented CGD-TCL and SPTL-AB, respectively; others were presumed to have SPTL-AB. Bexarotene was administered at flat doses corresponding to 91 to 339 mg/m2/d. Two of 15 patients received concurrent denileukin diftitox. Two children received bexarotene as maintenance therapy and were not evaluable for response. Results Among those treated with bexarotene alone, the overall response rate (ORR) was 82% (6/11 complete response [CR], 3/11 partial response [PR]). One of the 2 patients treated with concomitant denileukin diftitox responded for an ORR of 10/13 (77%), including 54% CR and 23% PR. Median progression-free survival was 38.4 months; median duration of response was 26.3 months. Six patients developed hypothyroidism and 9 developed hyperlipidemia; one patient developed dose-limiting hypertriglyceridemia. One pediatric patient developed insulin-dependent diabetes mellitus. Conclusions In this retrospective series, bexarotene showed a high response rate in SPTL-AB and CGD-TCL. It was generally well-tolerated with durable responses; therefore, bexarotene represents a promising therapy for children and adults with these disorders.

show abstract

“…Case reports describe durable responses with denileukin diftitox in cases of SPTL-AB. 19,20,21 Interferon-α is also reported to be active in refractory SPTL-AB. 18 …”

Section: Introductionmentioning

confidence: 99%

“…21 In this retrospective review, we report our experience treating 15 patients, including 3 children, with SPTL-AB and CGD-TCL with bexarotene.…”

Section: Introductionmentioning

confidence: 99%

Bexarotene Is Active Against Subcutaneous Panniculitis-Like T-Cell Lymphoma in Adult and Pediatric Populations

Mehta

Wayne

Kim

et al. 2012

Clinical Lymphoma Myeloma and Leukemia

View full text Add to dashboard Cite

show abstract

“…3 In addition, denileukin diftitox, a recombinant fusion protein of human interleukin-2 and diphtheria toxin, has recently been used successfully. 20 The course and pattern of disease progression in this case raises the question as to whether an earlier diagnosis may have changed our patient's outcome. However, the high rate of mortality described in SPTCL is well established to be secondary to the HPS accompanying the disorder in most cases, rather than dissemination of the lymphoma itself.…”

Section: Discussionmentioning

confidence: 87%

Unusual case of subcutaneous panniculitis‐like T‐cell lymphoma

Wells¹,

Kosky

Scolyer³

et al. 2004

Aust J Dermatology

View full text Add to dashboard Cite

An unusual case of subcutaneous panniculitis-like T-cell lymphoma is presented involving multiple organ systems, which eventually culminated in rapid demise from the haemophagocytic syndrome, after an initial protracted course. A 44-year-old man presented in April 2001 with bronchiolitis obliterans organising pneumonia that initially responded well to corticosteroids. However, the condition relapsed on attempted prednisone withdrawal in January 2002 and the patient was noted to have developed truncal subcutaneous nodules. Initial skin biopsy revealed lobular panniculitis, with negative microbiological culture. In July 2002, mononeuritis multiplex was diagnosed after the patient presented with paresthesiae and was treated with pulse cyclophosphamide therapy. By November 2002 there was ulceration of the subcutaneous nodules. Repeat skin biopsy revealed subcutaneous panniculitis-like T-cell lymphoma. The clinical manifestations were supportive of an unifying diagnosis of malignancy involving pulmonary, cutaneous and nervous systems. Combination chemotherapy with fludarabine, mitoxantrone and dexamethasone was commenced. However, the patient deteriorated, with fevers, weight loss, pancytopenia and laboratory features consistent with the haemophagocytic syndrome. Despite maximal supportive therapy the patient succumbed to his disease.

show abstract

“…Clinical regression of disease with corticosteroids and denileukin diftitox was seen in two cases with median duration of response for 6 months and more than 18 months. Furthermore, the addition of bexarotene to denileukin diftitox restored a clinical response in 1 of the patients after disease [64]. Interferon alpha is also reported to be active in refractory SPTCL [10].…”

Section: Discussionmentioning

confidence: 97%

Subcutaneous Panniculitis-like T-cell Lymphoma: Review of Therapies

S¹,

Chaudhari²

2015

Intern Med

View full text Add to dashboard Cite

Subcutaneous Panniculitis-like T-cell Lymphoma (SPTCL) is a rare subtype of cutaneous T-cell lymphoma derived from alpha/beta cytotoxic T-cells. It is known to follow an indolent course with a favorable prognosis. We review current therapies used to treat this rare entity in order to increase awareness about possible options. No standardized therapy for SPTL currently exists. Local radiotherapy for indolent local disease has been found successful. For indolent disease with a more generalized distribution, immunosuppressive agents as well as lowdose chemotherapy may be used. For aggressive presentations, combination chemotherapy, anthracycline-based regimens, fludarabine-based regimens, and rarely high-dose chemotherapy followed by hematopoietic stem cell transplant (SCT) with moderate success. By being aware of possible therapeutic options, a physician can recommend the most appropriate treatment for the individual.

show abstract

Denileukin Diftitox for the Treatment of Panniculitic Lymphoma

Cited by 22 publications

References 16 publications

Bexarotene Is Active Against Subcutaneous Panniculitis-Like T-Cell Lymphoma in Adult and Pediatric Populations

Bexarotene Is Active Against Subcutaneous Panniculitis-Like T-Cell Lymphoma in Adult and Pediatric Populations

Unusual case of subcutaneous panniculitis‐like T‐cell lymphoma

Subcutaneous Panniculitis-like T-cell Lymphoma: Review of Therapies

Contact Info

Product

Resources

About