Kerl K, Prins C, Cerroni L, French L E
Department of Dermatology, Geneva University Medical School, 24 rue Micheli-du-Crest, CH-1211 Geneva 14, Switzerland.
Br J Dermatol. 2006 May;154(5):988-91. doi: 10.1111/j.1365-2133.2006.07151.x.
Denileukin diftitox (Ontak) is a fusion protein comprising a diphtheria toxin and an interleukin (IL)-2 moiety that specifically targets CD25 (IL-2 receptor)-positive tumour cells. We report a patient with rapidly progressive Epstein-Barr virus-positive nasal type extranodal natural killer/T-cell lymphoma (extranodal NKTCL), treated with a combination of denileukin diftitox (Ontak) and oral bexarotene (Targretin). A significant regression of the cutaneous tumours was observed already after the first cycle of denileukin diftitox and was maintained for a period of 5 months with monthly cycles of denileukin diftitox. The treatment was well tolerated. Following this response the patient decided to stop the treatment. He was then followed by his oncologist and lost from dermatological follow-up. Shortly after treatment withdrawal the disease progressed and the patient received one cycle of doxorubicin (Caelyx). He died from septic shock syndrome 2 months later. To our knowledge this is the first case of extranodal NKTCL treated with denileukin diftitox and bexarotene. A striking, albeit transient, response occurred with this therapy. Combination treatment with denileukin diftitox and bexarotene should be further assessed in this aggressive type of cutaneous lymphoma.
地尼白介素-匹地毒素（Ontak）是一种融合蛋白，由白喉毒素和白细胞介素（IL）-2部分组成，可特异性靶向CD25（IL-2受体）阳性肿瘤细胞。我们报告了一名患有快速进展性爱泼斯坦-巴尔病毒阳性鼻型结外自然杀伤/T细胞淋巴瘤（结外NKTCL）的患者，接受了地尼白介素-匹地毒素（Ontak）和口服贝沙罗汀（Targretin）联合治疗。在第一个地尼白介素-匹地毒素周期后，皮肤肿瘤就出现了显著消退，并在每月进行地尼白介素-匹地毒素周期治疗的情况下维持了5个月。该治疗耐受性良好。出现这种反应后，患者决定停止治疗。随后他由肿瘤学家进行随访，皮肤科随访失访。治疗停药后不久，疾病进展，患者接受了一个阿霉素（凯素）周期治疗。2个月后，他死于感染性休克综合征。据我们所知，这是首例用地尼白介素-匹地毒素和贝沙罗汀治疗的结外NKTCL病例。这种治疗产生了显著的反应，尽管是短暂的。地尼白介素-匹地毒素和贝沙罗汀联合治疗应在这种侵袭性皮肤淋巴瘤中进一步评估。
