Department of Dermatology, Emory University, Atlanta, Georgia 30322, USA.
J Am Acad Dermatol. 2013 Feb;68(2):247-54. doi: 10.1016/j.jaad.2012.07.013. Epub 2012 Aug 20.
Bexarotene is the only Food and Drug Administration-approved retinoid for the treatment of cutaneous T-cell lymphoma (CTCL) and is associated with a relatively high frequency of adverse effects. Acitretin has anecdotally been reported to be effective for CTCL.
We sought to determine the effectiveness and tolerability of acitretin as primary or adjuvant therapy for CTCL.
We conducted a retrospective chart review of patients with CTCL treated with acitretin at a single tertiary care center.
A total of 32 patients with CTCL were included: 29 had mycosis fungoides, 2 had Sézary syndrome, and 1 had CTCL not otherwise specified. Median patient age was 55 years; 56% were male; 47% were white, 47% black, and 6% other. In all, 3% of patients were stage IA, 69% stage IB/IIA, 16% stage IIB, 6% stage III, and 6% stage IV. Six patients received acitretin alone; 26 received acitretin in addition to another CTCL therapy. The overall response rate was 59%. In all, 25% of patients had stable disease and 16% had progressive disease. Median duration of response was 28 months. Adverse effects were generally mild with 5 patients discontinuing therapy because of these.
In this small retrospective chart review, many patients were on other CTCL therapies while on acitretin; therefore precise assessment of response to acitretin alone was difficult.
Acitretin is well tolerated and potentially effective for early-stage CTCL. Response to acitretin, either as adjuvant therapy monotherapy, is comparable with the response to oral agents currently approved for this disease.
贝沙罗汀是唯一经美国食品药品监督管理局批准用于治疗皮肤 T 细胞淋巴瘤（CTCL）的类视黄醇药物，其不良反应发生率相对较高。阿维 A 酯有报道称对 CTCL 有效。
我们旨在确定阿维 A 酯作为 CTCL 的一线或辅助治疗的有效性和耐受性。
我们对一家三级保健中心接受阿维 A 酯治疗的 CTCL 患者进行了回顾性图表审查。
共纳入 32 例 CTCL 患者：29 例蕈样真菌病，2 例 Sezary 综合征，1 例未特指 CTCL。患者中位年龄为 55 岁；56%为男性；47%为白人，47%为黑人，6%为其他种族。所有患者中，3%为 IA 期，69%为 IB/IIA 期，16%为 IIB 期，6%为 III 期，6%为 IV 期。6 例患者单独接受阿维 A 酯治疗；26 例患者在接受阿维 A 酯治疗的同时还接受了另一种 CTCL 治疗。总体缓解率为 59%。所有患者中，25%病情稳定，16%病情进展。缓解持续时间的中位数为 28 个月。不良反应一般较轻，有 5 例患者因不良反应而停止治疗。
在这项小型回顾性图表审查中，许多患者在接受阿维 A 酯治疗的同时还接受了其他 CTCL 治疗；因此，单独评估阿维 A 酯的疗效较为困难。
阿维 A 酯耐受性良好，对早期 CTCL 可能有效。阿维 A 酯作为辅助治疗或单药治疗的疗效与目前批准用于治疗该疾病的口服药物相当。
