Brentuximab-induced hand-foot syndrome in a Hodgkin lymphoma patient

Abstract

Dear Editor, Hodgkin's lymphoma accounts for approximately 30 % of all lymphomas. It is a highly curable condition with a 5-year survival above 85 %, which is even higher in patients with a limited stage disease [1]. Hodgkin's lymphoma (HL) that has relapsed after or is refractory to an autologous bone marrow transplant presents an ongoing treatment challenge [2]. Brentuximab vedotin (SGN-35) is an antibody-drug conjugate directed against the CD30 antigen expressed on HL. SGN-35 is usually well-tolerated but can cause various side effects, with some more likely to occur than others. A mild skin rash may occur during treatment. This may be treated with antihistamines and simple creams. Rarely, patients may develop a more serious skin reaction, as in our case, necessitating a dose reduction or discontinuation of treatment [3].A 51-year-old man with Hodgkin's lymphoma (HL) presented with severe pain, itching, and maculopapular rash on his hands and feet starting 2 days after a second cycle of brentuximab administered as a single agent. He had been previously treated for stage IV B HL with a standard chemotherapy regimen comprising doxorubicin, bleomycin, vinblastine, and dacarbazine for six cycles. Three years later, he relapsed and was treated with ifosfamide, carboplatin, and etoposide followed by autologous bone marrow transplantation. The treatment course was complicated with pulmonary embolism, treated with rivaroxaban. He relapsed 6 months after transplantation and was treated with brentuximab, a CD30 monoclonal antibody (mAb) used with promising results in relapsed or refractory HL. The patient developed a severe hand-foot syndrome. He has a maculopapular rash with cracking of the skin with a fissure formation below the ring and middle fingers ( Fig.

The diverse landscape of dermatologic toxicities of non‐immune checkpoint inhibitor monoclonal antibody‐based cancer therapy

“…Infrequently, authors have documented TEN and DRESS syndrome with anti‐CD30 mAb use 116,200 . Table 3 lists the types of dermatologic toxicities seen with mAbs targeting CD30, including reports of the clinical aspects of dermatologic toxicities to those listed 127 …”

“…116,200 Table 3 lists the types of dermatologic toxicities seen with mAbs targeting CD30, including reports of the clinical aspects of dermatologic toxicities to those listed. 127…”

Brentuximab-induced hand-foot syndrome in a patient with cutaneous T-cell lymphoma

“…The efficacy of BV relies on its internalization into target cells, trafficking to lysosomes, and cleavage of cytotoxic MMAE from its conjugate monoclonal antibody by cysteine proteases; 5 therefore, a proposed mechanism for brentuximab-induced HFS is overaccumulation of cytotoxic MMAE in palmar and acral skin due to increased cleavage by lysosomal cysteine proteases. A literature review produced one reported case of HFS in a patient with Hodgkin lymphoma after a second infusion of BV, 6 and a single reported case of grade 2 HFS in a patient with Sézary syndrome during BV therapy. 7 …”