Progression of Undiagnosed Cutaneous T-Cell Lymphoma During Efalizumab Therapy

Hernandez, Claudia; Worobec, Sophie M.; Gaitonde, Sujata; Kiripolsky, Monika L.; Aquino, Kristen

doi:10.1001/archdermatol.2008.530

Cited by 17 publications

(20 citation statements)

References 2 publications

(6 reference statements)

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“…In a few case reports of lymphoma developing in patients with psoriasis, the authors felt that the lymphoma had been present before the start of biologic therapy, and that the treatment allowed the lymphoma cells to grow unopposed (44,62,63). In two of these cases, an initial diagnosis of psoriasis was made, which was retrospectively proven to be CTCL by biopsy.…”

Section: Evidence From Case Reports and Case Seriesmentioning

confidence: 99%

Is there truly a risk of lymphoma from biologic therapies?

Dommasch¹,

Gelfand

2009

Dermatologic Therapy

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The treatment of psoriasis has undergone a revolution with the advent of biologic therapies, including infliximab, etanercept, adalimumab, efalizumab, and alefacept. Biologics are generally safe and well tolerated. However, there has been concern over the risk of lymphoma with use of these agents due to their immunosuppressive properties. This review summarizes the current evidence in regards to lymphoma risk with biologic therapy obtained from case reports and case series, observational studies, clinical trials, and meta-analyses. The majority of data for T-cell inhibitors comes from case reports and relatively small, short term clinical trials. In addition to published case reports and case series, TNF-α inhibitors have also been studied extensively in large cohort studies and meta-analyses of clinical trials derived primarily from the rheumatoid arthritis population. Current data are not sufficient to completely rule out an increased risk of lymphoma associated with biologics, nor has a causal relationship between lymphoma and biologics been well established. Short- to intermediate-term treatment with biologics (e.g. up to 4 years) appears to be very safe with respect to lymphoma risk, especially with TNF-α inhibitors in which their potential risks appear to be well defined. Continued vigilance is warranted, however, in the appropriate patient, the risk-to-benefit profile of psoriasis treatment with respect to lymphoma risk appears highly favorable.

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Section: Evidence From Case Reports and Case Seriesmentioning

confidence: 99%

Is there truly a risk of lymphoma from biologic therapies?

Dommasch¹,

Gelfand

2009

Dermatologic Therapy

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show abstract

“…In recent years, the onset of cutaneous or extracutaneous lymphomas has been described also in patients undergoing treatment with immunosuppressive or immunomodulatory drugs ("biologics") [5][6][7][8][9][10]. In some of these cases, a wrong diagnosis of atopic dermatitis or psoriasis had been made and treatment with one of the many immunologic agents had been started, resulting in rapid progression of an undiagnosed mycosis fungoides (see also Chapter 2) [7][8][9]. These particular cases have been termed "monoclonal antibody immunomodulator-related lymphoid proliferations" [10].…”

Section: Cutaneous Lymphoproliferative Disorders In Other Iatrogenic mentioning

confidence: 99%