低剂量口服贝沙罗汀联合低剂量干扰素α治疗皮肤T细胞淋巴瘤：临床协同作用及可能的免疫机制

Low-dose oral bexarotene in combination with low-dose interferon alfa in the treatment of cutaneous T-cell lymphoma: clinical synergism and possible immunologic mechanisms.

作者信息

McGinnis Karen S, Junkins-Hopkins Jacqueline M, Crawford Glen, Shapiro Michael, Rook Alain H, Vittorio Carmela C

机构信息

Department of Dermatology, University of Pennsylvania School of Medicine, 3600 Spruce Street, Philadelphia, PA 19104-4283, USA.

出版信息

J Am Acad Dermatol. 2004 Mar;50(3):375-9. doi: 10.1016/j.jaad.2003.10.669.

DOI:10.1016/j.jaad.2003.10.669

PMID:14988678

Abstract

BACKGROUND

For nearly 2 decades clinicians have been treating cutaneous T-cell lymphoma (CTCL) with regimens that combine interferon alfa with retinoid compounds. In December 1999 a new retinoid, bexarotene, was approved by the US Food and Drug Administration for the treatment of CTCL. At the manufacturer's recommended dose of bexarotene (300 mg/m(2) of body surface area), it has proven to be a highly effective therapy for all stages of CTCL. Nevertheless, this dose is typically associated with adverse effects including severe hyperlipidemia. Furthermore, there appears to be no standardization of dosing among physicians who treat CTCL.

OBSERVATIONS

We present 3 representative patients, 2 with erythrodermic CTCL and 1 with follicular mycosis fungoides, who experienced the rapid clearing of skin disease while being treated with a combination of low-dose bexarotene and low-dose recombinant interferon alfa.

CONCLUSIONS

Combining low-dose bexarotene with low-dose interferon alfa was well tolerated and led to rapid improvement in our patients. We review the clinical and biologic basis for this approach.

摘要

背景

近20年来，临床医生一直使用将干扰素α与类视黄醇化合物联合的方案治疗皮肤T细胞淋巴瘤（CTCL）。1999年12月，一种新型类视黄醇药物贝沙罗汀获美国食品药品监督管理局批准用于治疗CTCL。在制造商推荐的贝沙罗汀剂量（300mg/m²体表面积）下，它已被证明是治疗各阶段CTCL的高效疗法。然而，该剂量通常会伴随包括严重高脂血症在内的不良反应。此外，治疗CTCL的医生之间似乎没有剂量标准化。