成人T细胞白血病/淋巴瘤患者使用莫加莫拉单抗后发生的放射性皮炎：一项多机构回顾性研究

Radiation-induced dermatitis after administration of mogamulizumab for adult T-cell leukaemia/lymphoma: a multi-institutional retrospective study.

作者信息

Maemoto Hitoshi, Ariga Takuro, Kusada Takeaki, Heianna Joichi, Manabe Yoshihiko, Miyakawa Akifumi, Nakachi Sawako, Morishima Satoko, Iraha Shiro, Ganaha Fumikiyo, Masuzaki Hiroaki, Murayama Sadayuki

机构信息

Department of Radiology, Okinawa Prefectural Nanbu Medical Center & Children's Medical Center, Okinawa, Japan.

Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Japan.

出版信息

Jpn J Clin Oncol. 2019 Feb 1;49(2):153-159. doi: 10.1093/jjco/hyy172.

DOI:10.1093/jjco/hyy172

PMID:30452692

Abstract

BACKGROUND

Cutaneous adverse reactions are frequently induced by mogamulizumab. Cases of Stevens-Johnson syndrome, toxic epidermal necrolysis and severe photosensitivity related to mogamulizumab have been reported. This study investigated whether severe radiation-induced dermatitis occurred in patients undergoing radiotherapy after the administration of mogamulizumab for adult T-cell leukaemia/lymphoma.

METHODS

We retrospectively reviewed 46 courses of radiotherapy administered to 15 consecutive patients with adult T-cell leukaemia/lymphoma (acute, n = 7; lymphoma, n = 7; smouldering, n = 1) who received mogamulizumab before or during radiotherapy at three institutions between 2012 and 2017.

RESULTS

During 43 of the 46 radiotherapy courses, patients developed Grade ≤1 radiation-induced dermatitis. No patient developed Grade ≥3 radiation-induced dermatitis. No patient was prescribed ointments as prophylactic treatment for radiation-induced dermatitis. Development of radiation-induced dermatitis was not significantly associated with the number of days since the administration of mogamulizumab prior to radiotherapy (P = 0.85), frequency of administration of mogamulizumab before/during radiotherapy (P = 0.33), administration of mogamulizumab during radiotherapy (P = 0.41) or types of lesions in adult T-cell leukaemia/lymphoma cases (cutaneous vs. non-cutaneous, P = 0.74). Development of radiation-induced dermatitis was significantly related to the total cutaneous dose (mean, 31.9 Gy [95% confidence interval: 26.6-37.1 Gy] vs. 19.7 Gy [95% confidence interval: 16.2-23.2 Gy], P = 0.0004) and total prescribed dose (mean, 31.5 Gy [95% confidence interval: 26.2-36.8 Gy] vs. 18.5 Gy [95% confidence interval: 15.0-22.0 Gy], P = 0.0002).

CONCLUSION

None of the 15 patients who received moderate-dose radiotherapy developed severe radiation-induced dermatitis during the 46 courses of radiotherapy after mogamulizumab administration.

摘要

背景

莫加莫珠单抗常引起皮肤不良反应。已报告了与莫加莫珠单抗相关的史蒂文斯 - 约翰逊综合征、中毒性表皮坏死松解症和严重光敏反应病例。本研究调查了接受莫加莫珠单抗治疗成人T细胞白血病/淋巴瘤后接受放疗的患者是否发生严重放射性皮炎。

方法

我们回顾性分析了2012年至2017年间在三个机构对15例连续的成人T细胞白血病/淋巴瘤患者（急性，n = 7；淋巴瘤，n = 7；冒烟型，n = 1）进行的46个放疗疗程，这些患者在放疗前或放疗期间接受了莫加莫珠单抗治疗。

结果

在46个放疗疗程中的43个疗程中，患者发生了≤1级放射性皮炎。没有患者发生≥3级放射性皮炎。没有患者被开药膏作为放射性皮炎的预防性治疗。放射性皮炎的发生与放疗前莫加莫珠单抗给药后的天数（P = 0.85）、放疗前/放疗期间莫加莫珠单抗的给药频率（P = 0.33）、放疗期间莫加莫珠单抗的给药（P = 0.41）或成人T细胞白血病/淋巴瘤病例的病变类型（皮肤性与非皮肤性，P = 0.74）均无显著相关性。放射性皮炎的发生与总皮肤剂量（平均，31.9 Gy [95%置信区间：26.6 - 37.1 Gy]对19.7 Gy [95%置信区间：16.2 - 23.2 Gy]，P = 0.0004）和总处方剂量（平均，31.5 Gy [95%置信区间：26.2 - 36.8 Gy]对18.5 Gy [95%置信区间：15.0 - 22.0 Gy]，P = 0.0002）显著相关。