Machan Salma, Plaza Carlos, Pérez-González Yosmar, Rodriguez-Pinilla Maria, Requena Luis, Cordoba Raul
Department of Dermatology, Fundación Jiménez Díaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain.
Lymphoma Unit, Department of Hematology, Oncohealth Institute, Fundación Jimenez Diaz University Hospital, Health Research Institute IIS-FJS, Autonomous University of Madrid, Madrid, Spain.
J Med Case Rep. 2020 Feb 24;14(1):35. doi: 10.1186/s13256-020-2344-9.
Follicular lymphoma is an indolent non-Hodgkin lymphoma that is most commonly diagnosed in elderly individuals. The majority of patients with follicular lymphoma present with advanced disease. Despite the recent advances in treatment, there remains a substantial unmet need for effective treatments for patients with relapsed/refractory follicular lymphoma. The PI3Kδ inhibitor idelalisib was approved by the European Medicines Agency in 2014 as a monotherapy for the treatment of adult patients with follicular lymphoma that is refractory to two prior lines of treatment. Real-world evidence from patients with follicular lymphoma treated with idelalisib indicates its utility in these patients.
This case report describes an 82-year-old, retired, white, female patient with refractory follicular lymphoma who achieved a partial response with idelalisib treatment. Despite experiencing two incidences of a psoriasis-like rash during idelalisib treatment that required effective management with topical steroids, the patient was able to restart treatment successfully and maintain a continued partial response.
The clinical relevance of the effective management of adverse events in this case demonstrates the opportunity to enable patients to remain on therapy, thereby maintaining long-term response and improving overall outcomes.
滤泡性淋巴瘤是一种惰性非霍奇金淋巴瘤，最常见于老年患者。大多数滤泡性淋巴瘤患者就诊时已处于晚期。尽管近年来治疗取得了进展，但复发/难治性滤泡性淋巴瘤患者对有效治疗仍有大量未满足的需求。PI3Kδ抑制剂idelalisib于2014年被欧洲药品管理局批准作为单一疗法，用于治疗对先前两线治疗均耐药的成年滤泡性淋巴瘤患者。来自接受idelalisib治疗的滤泡性淋巴瘤患者的真实世界证据表明了其在这些患者中的效用。
本病例报告描述了一名82岁、退休、白人、患有难治性滤泡性淋巴瘤的女性患者，她接受idelalisib治疗后获得了部分缓解。尽管在idelalisib治疗期间出现了两例银屑病样皮疹，需要使用外用类固醇进行有效处理，但患者能够成功重新开始治疗并维持持续的部分缓解。
本病例中不良事件的有效管理所具有的临床意义表明，有机会使患者继续接受治疗，从而维持长期缓解并改善总体预后。
