Office of the Medical Directorate, University Hospital of Zürich, Zürich, Switzerland.
Department of Pathology, University Hospital of Zürich, Zürich, Switzerland.
JAMA Dermatol. 2015 Jan;151(1):73-7. doi: 10.1001/jamadermatol.2014.1629.
The prognosis of advanced cutaneous T-cell lymphoma (CTCL), including Sézary syndrome and mycosis fungoides (MF), is poor. So far, no curative option apart from allogeneic stem cell transplantation is available. Large cell transformation often hallmarks cases with a more aggressive clinical course, and large tumor cells may express CD30. Recently, brentuximab vedotin, a conjugate of an anti-CD30 antibody and monomethylauristatin E, which inhibits the polymerization of microtubuli, has produced promising results in phase 2 trials in CD30+ Hodgkin lymphoma and anaplastic large cell lymphoma.
We describe 4 patients with advanced CTCL, 3 with MF and 1 with Sézary syndrome, who were treated with brentuximab. All patients had received multiple previous systemic therapies. In 2 cases of MF, a remission enabling subsequent allogeneic stem cell transplantation was achieved.
Brentuximab is a well-tolerated, promising new treatment option for advanced CTCL that can be integrated in an allogeneic stem cell transplantation plan by selectively depleting malignant CD30+ cutaneous lymphoma cells.
晚期皮肤 T 细胞淋巴瘤（CTCL），包括蕈样真菌病和赛泽里综合征（Sézary syndrome），预后较差。除了异基因干细胞移植外，目前尚无其他治愈方法。大细胞转化通常是疾病具有侵袭性临床病程的标志，并且大肿瘤细胞可能表达 CD30。最近，一种由抗 CD30 抗体和单甲基奥瑞他汀 E 组成的偶联物 Brentuximab vedotin，可抑制微管聚合，在 CD30+霍奇金淋巴瘤和间变大细胞淋巴瘤的 2 期试验中取得了有希望的结果。
我们描述了 4 例晚期 CTCL 患者，3 例为蕈样真菌病，1 例为赛泽里综合征，他们接受了 Brentuximab 治疗。所有患者均接受过多线系统治疗。在 2 例蕈样真菌病患者中，达到了缓解，随后进行了异基因干细胞移植。
Brentuximab 是一种耐受性良好的新型治疗晚期 CTCL 的方法，通过选择性清除恶性 CD30+皮肤淋巴瘤细胞，可整合到异基因干细胞移植方案中。
