Cutaneous T-cell lymphoma (CTCL) is a malignant, lymphoproliferative disease of CD4+ skin-trafficking T cells. Sézary syndrome (SS), the erythrodermic variant, is typically characterized by circulating malignant T cells. Bexarotene, a retinoid X receptor–specific retinoid, has been available for SS treatment since 2000. A subset of patients with SS treated with bexarotene do not respond clinically, which may correlate with the findings of Budgin et al1 that the malignant T cells from some patients with SS are resistant in vitro to the apoptotic effects of bexarotene.
Newton SB, Yoon JS, Benoit BM, Wysocka M, Rook AH. Apoptotic Responses to All-trans Retinoic Acid of Targretin-Resistant, Malignant, CD4+ Peripheral Blood T Cells From Patients With Sézary Syndrome. Arch Dermatol. 2007;143(5):659-675. doi:10.1001/archderm.143.5.661