Aggressive cutaneous T-cell lymphomas after TNFα blockade

Adams, A. Elizabeth; Zwicker, Jeffrey I.; Curiel, Clara; Kadin, Marshall E.; Falchuk, Kenneth R.; Drews, Reed E.; Kupper, Thomas S.

doi:10.1016/j.jaad.2004.03.047

Cited by 93 publications

(66 citation statements)

References 18 publications

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“…23 It is uncertain if cessation of immunomodulator agent therapy can cause regression of associated lymphomas; one follicular lymphoma case in our series progressed in spite of cessation of infilximab therapy and a case of aggressive T-cell lymphoma after etanercept therapy failed to respond to cessation of therapy and progressed rapidly. 24 However, regression of a diffuse large B-cell lymphoma after cessation of in fliximab without the use of cytotoxic chemotherapy has been reported. 15 Thus, it is possible that some of these IAR-LPD may respond to cessation of the immunomodulator therapy, similar to the regression of some methotrexateassociated lymphomas.…”

Section: Discussionmentioning

confidence: 99%

Immunomodulator agent-related lymphoproliferative disorders

Hasserjian

Chen²,

Perkins

et al. 2009

Modern Pathology

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The recent development of inhibitors of key immune response proteins has revolutionized the therapy of autoimmune diseases; these immunomodulator agents include monoclonal antibodies and receptor antagonists. However, as with all therapies, these new agents are not without side effects and complications. In particular, anti-tumor necrosis factor alpha (TNFa) agents have been reported to be associated with an increased incidence of lymphoproliferative disorders, infections, and vasculitis. We evaluated the clinicopathological features of 18 cases of immunomodulator agent-related lymphoproliferative disorders (IAR-LPD) from several institutions. These included 6 cases of B-cell lymphoma, 2 cases of T-cell lymphoma, 3 cases of classical Hodgkin lymphoma, and 7 atypical lymphoid proliferations that did not fulfill diagnostic criteria for lymphoma; two of the latter regressed after discontinuation of the immunomodulator agent therapy. All eight lymphoma patients with available information had also received prior chemotherapy (methotrexate or 6-mercaptopurine). EBV was strongly associated with the B-cell and classical Hodgkin lymphomas. This case series illustrates that a broad range of lymphoid proliferations can occur after immunomodulator agent therapy and that these immunomodulator agent-related lymphoproliferative disorders have considerable overlap with other well-defined lymphoproliferative diseases associated with iatrogenic immunosuppression. Further study is warranted to evaluate how these therapies interact with other immunosuppressive agents and the underlying abnormal immune system to enhance the development of lymphomas and atypical lymphoid proliferations.

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Section: Discussionmentioning

confidence: 99%

Immunomodulator agent-related lymphoproliferative disorders

Hasserjian

Chen²,

Perkins

et al. 2009

Modern Pathology

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“…Data from experimental studies suggest that the T-cell repertoire in CTCL patients is significantly contracted [27] Immunological abnormalities in CTCL are typically associated with depressed ability of peripheral blood cells to produce the Th 1 cytokines, interferon gamma and IL-2 as a result of Th 2 skewing. [28][29][30][31][32][33][34][35][36][37] During CTCL progression, reduced T-cell-mediated cellular immune responses and diminished natural killer cell activity also develop [38,39] Wysocka et al have demonstrated a direct relationship between the extend of the pool of circulating malignant T-cells and an impaired immune response [40]. Also the functions of natural killer (NK) cells, including cellular cytotoxicity and production of interferon IFN-γ, become increasingly impaired as the circulating tumor burden increases.…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Chlamydophila pneumoniae in the Blood Samples of Patients with Primary Cutaneous Lymphomas

Nedoszytko¹,

Pm²,

Karenko³

et al. 2017

J Transm Dis Immun

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“…79 Treatment may slightly increase the risk of melanocytic and nonmelanocytic skin cancers, including squamous cell carcinoma, basal cell carcinoma, and cutaneous T cell lymphoma. 80,81 A comprehensive observational study reported that patients receiving TNF-α inhibitors for rheumatoid arthritis had a 1.5 odds ratio for nonmelanocytic skin cancers and a trend towards increased risk of melanoma (odds ratio 2.3). 82 The increased risk of lymphoma and other solid organ cancers is less clear.…”

Section: 73mentioning

confidence: 99%

Biologics in the treatment of psoriasis and emerging new therapies in the pipeline

Levy¹,

Solomon²,

Emer³

2012

PTT

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Elucidation of the immunopathogenesis of psoriasis has led to the discovery of novel biologic agents for the treatment of moderate-to-severe plaque psoriasis. There are currently five biologic agents approved by the US Food and Drug Administration for psoriasis which have proven to be quite efficacious in clinical trials and in post-marketing and clinical experience. As more details are uncovered about the immunologic pathways involved in initiation and maintenance of this disease, there will be an increasing development and marketing of novel therapeutics. It is crucial to understand the immunopathogenesis of psoriasis and the mechanisms of these novel agents in order to to treat the psoriatic population effectively and mitigate disease burden. This article reviews the currently approved biologics for the treatment of psoriasis, with emphasis on efficacy and safety. There are countless therapies currently in the research pipeline, with mechanisms ranging from receptor antagonism to signal transduction pathway inhibition. The initial trials and future studies involving these new agents are also reviewed. As therapeutics escalate through the research pipeline, the management and treatment of psoriasis will likely become more manageable for practitioners and patients.

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Aggressive cutaneous T-cell lymphomas after TNFα blockade

Cited by 93 publications

References 18 publications

Immunomodulator agent-related lymphoproliferative disorders

Immunomodulator agent-related lymphoproliferative disorders

The Prevalence of Chlamydophila pneumoniae in the Blood Samples of Patients with Primary Cutaneous Lymphomas

Biologics in the treatment of psoriasis and emerging new therapies in the pipeline

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