Bexarotene Is a New Treatment Option for Lymphomatoid Papulosis

Abstract

Background: Lymphomatoid papulosis (LyP) is a clonal T cell proliferation with large cell histology, a chronic course, and an increased risk of lymphoma. Bexarotene (Targretin^®) is an RXR-selective retinoid (rexinoid) approved for the cutaneous manifestations of cutaneous T cell lymphoma. Objective: To determine whether bexarotene is effective in treating LyP. Methods: Ten patients with chronic and symptomatic LyP were prospectively treated with oral (n = 3) or topical gel (n = 7) formulations of bexarotene. Results: A favorable response to bexarotene treatment with decreased numbers or duration of lesions was seen in all with objective responses in 8 patients. Conclusions: Bexarotene may be an effective palliative treatment for LyP, warranting further controlled studies.

EORTC, ISCL, and USCLC consensus recommendations for the treatment of primary cutaneous CD30-positive lymphoproliferative disorders: lymphomatoid papulosis and primary cutaneous anaplastic large-cell lymphoma*

“…80,97 CR was observed in one of 3 patients treated with oral bexarotene (150-650 mg, orally daily) in a prospective, uncontrolled, nonrandomized study. 95 Topical bexarotene resulted in CR in only one patient after 13 months and PR in 4 of 7 patients without data on follow-up. 95 Radiotherapy has been used with various techniques and protocols.…”

“…95 Topical bexarotene resulted in CR in only one patient after 13 months and PR in 4 of 7 patients without data on follow-up. 95 Radiotherapy has been used with various techniques and protocols. 10,12,15,77,84,85,98,99 Controversial results were seen with Grenz ray irradiation, which resulted in complete regression of treated lesions in 6 patients 77 but had no effect in another series of 3 patients.…”

“…76,80,88,[91][92][93][94][95] CR was observed in 4 of 5 patients after 2-6 weeks of treatment with 3-15 MU IFN-␣ per week in an open trial. 94 Discontinuation resulted in relapses within 3-4 weeks and the necessity for maintenance therapy over 10-17 months.…”

Subcutaneous Panniculitis-like T-cell Lymphoma: Review of Therapies

“…Median progression free survival 38.4 months and median duration of response was 26.3 months [30]. The most common toxicities noted with bexarotene are similar to those observed in patients with other types of cutaneous T-cell lymphomas including hypothyroidism and hypertriglyceridemia [59][60][61][62]. It represents a less toxic alternative to chemotherapy that can result in durable disease control.…”

A Case of Lymphomatoid Papulosis Limited to Becker's Melanosis

“…Anti-inflammatory therapy with doxycycline 100 mg twice daily for 6 weeks showed only minimal effect. The patient was then started on bexarotene, a well-established therapy option for cutaneous T cell lymphoma that has also been described to be effective in LyP [8]. Initial dosage was 150 mg/m 2 daily, later increased to 300 mg/m 2 daily, but reduced to 150 mg/m 2 after 8 months because of diarrhea and dizziness.…”