Several promising therapies have emerged for advanced-stage cutaneous T-cell lymphoma (CTCL), which has a poor prognosis. We report a case of CD30-negative mycosis fungoides (MF) with a complete response to brentuximab vedotin, a therapy targeted against CD30.
A man in his 60s with stage IIB MF (T3N1M0B0a) was treated with topical clobetasol, topical imiquimod, psoralen–UV-A phototherapy, interferon alfa, interferon gamma, and localized radiotherapy, and all treatments failed. He had a nearly complete response to oral bexarotene and total skin electron beam therapy. However, while undergoing maintenance bexarotene and narrowband UV-B therapy, he developed plaques and ulcerated tumors involving 30% of the body surface (Figure 1), along with fludeoxyglucose-avid lymphadenopathy. A skin biopsy showed large-cell transformation with less than 1% CD30 expression by routine immunohistochemical analysis. His disease progressed after 3 cycles of romidepsin, and he was switched to gemcitabine chemotherapy, but in the first cycle developed neutropenia, infection, and failure to thrive, which prompted preliminary discussions regarding hospice care.
Zhang C, Chairatchaneeboon M, Haun P, Landsburg D, Kim EJ. Treatment of CD30-Negative Refractory Mycosis Fungoides With Brentuximab Vedotin. JAMA Dermatol. 2018;154(1):109–110. doi:10.1001/jamadermatol.2017.3961
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: