Lethal anaplastic large-cell lymphoma occurring in a patient treated with dupilumab

Du-Thanh, A.; Gustave, Valentin; Dereure, O.

doi:10.1016/j.jdcr.2021.09.020

Cited by 11 publications

(8 citation statements)

References 10 publications

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“…The other three patients all had known CTCL and received dupilumab off‐licence for severe pruritus; all three had disease progression following dupilumab, and two of these died due to disease progression. To date, two other cases of a patient dying due to CTCL within months of receiving dupilumab for AD have been reported 3,4 . Questions have previously been raised about the safety of biologics used for psoriasis in patients with CTCL, 5 and ciclosporin has been associated with CTCL progression in case reports 6 …”

Section: Figurementioning

confidence: 99%

Dupilumab unmasking cutaneous T‐cell lymphoma: report of a fatal case

Poyner

Bacon

Osborne

et al. 2022

Clin Experimental Derm

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We present a 60‐year‐old man who was started on dupilumab for severe atopic dermatitis. After initial improvement his skin deteriorated and ‘unmasked’ cutaneous T cell lymphoma, which rapidly progressed resulting in his death 12 months after dupilumab was stopped. This case adds to the evidence that dupilumab can cause CTCL progression and highlights the importance of re‐evaluating patient diagnosis to exclude CTCL prior to starting this biologic.

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Section: Figurementioning

confidence: 99%

Dupilumab unmasking cutaneous T‐cell lymphoma: report of a fatal case

Poyner

Bacon

Osborne

et al. 2022

Clin Experimental Derm

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“…No improvement in skin condition was noted in these cases, whereas another case describing Dupilumab administration for a patient diagnosed from the start with SS noted a great improvement in skin disease, pruritus, and quality of life [ 39 ]. A case of anaplastic large-cell lymphoma, which developed after complete clearance of AD with Dupilumab and that led to the patient’s death, has also been reported [ 40 ]. Given the contradictory results in many studies, it still remains a debate whether Dupilumab induces the development of CTCL, opposite to the expected outcome of improving such conditions, given the pathogenesis of cutaneous lymphomas.…”

Section: Discussionmentioning

confidence: 99%

Atopic Dermatitis with Multiple Comorbidities Treated with Dupilumab. A Case Report and Review of the Literature Regarding the Safety of Dupilumab

Mitroi

Stoica

Mitroi

et al. 2022

Life

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Dupilumab is the only available biological treatment for moderate-to-severe atopic dermatitis (AD). Even so, limited clinical data regarding its safety profile are available. Interactions with other drugs and the adverse effects of Dupilumab on patients with multiple comorbidities, such as chronic heart disease, diabetes, chronic kidney disease, etc., are not known yet. Moreover, there have been described cases of cutaneous lymphomas induced by Dupilumab. Therefore, the clinician that wants to start treatment for moderate-to-severe atopic dermatitis, which does not respond to conventional drugs, might be reluctant to choose biologic agents such as Dupilumab. In this paper, we reported a case of severe atopic dermatitis with multiple comorbidities in which the patient was successfully treated with Dupilumab despite numerous underlying conditions. We also conducted a review of the current literature on the safety profile of Dupilumab in special categories of patients with comorbidities, such as heart, kidney, and liver disease, oncologic conditions, and during pregnancy.

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“… 158-164 Furthermore, other types of lymphomas such as anaplastic large-cell lymphoma, cytotoxic T-cell lymphoma, angioimmunoblastic T-cell lymphoma, and Hodgkin lymphoma have been reported during DUP therapy. 165-169 The current available published data provide reassurance regarding the use of DUP in patients with a history of solid tumors, but caution must be exercised in the case of hematological malignancies.…”

Section: Patients With Neoplasm Historymentioning

confidence: 99%

Biologics and small molecules treatment for moderate-to-severe atopic dermatitis patients with comorbid conditions and special populations: an Italian perspective

Guglielmo,

Deotto,

Naldi

et al. 2023

Dermatol Reports

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This comprehensive review offers a detailed look at atopic dermatitis (AD) treatment in Italy, focusing primarily on the use of biologics and small molecules. In response to advancing knowledge of AD's causes and treatments, there's a global need for updated guidelines to provide physicians with a more comprehensive clinical perspective, facilitating personalized treatment strategies. Dupilumab, a groundbreaking biologic, gained approval as a significant milestone. Clinical trials demonstrated its ability to significantly reduce AD severity scores, with an impressive 37% of patients achieving clear or nearly clear skin within just 16 weeks of treatment. Real-world studies further support its efficacy across various age groups, including the elderly, with a safety profile akin to that of younger adults. Tralokinumab, a more recent approval, shows promise in clinical trials, particularly among younger populations. However, its real-world application, especially in older individuals, lacks comprehensive data. JAK inhibitors like Upadacitinib, baricitinib, and abrocitinib hold substantial potential for AD treatment. Nevertheless, data remains limited for patients over 75, with older adults perceived to carry a higher risk profile. Integrated safety analyses revealed individuals aged 60 and above experiencing major adverse cardiovascular events and malignancies, underscoring the need for cautious consideration. While these therapies offer promise, especially among younger patients, further research is essential to determine their safety and efficacy in various populations, including pediatric, geriatric, and those with comorbidities. This review highlights the evolving landscape of AD treatment, with biologics and small molecules emerging as potent tools to enhance the quality of life for AD-affected individuals.

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Lethal anaplastic large-cell lymphoma occurring in a patient treated with dupilumab

Abstract: From the Department of Dermatology a and INSERM U1058 ''Pathogenesis and control of chronic and emerging infections,'' University of Montpellier. b Funding sources: None. IRB approval status: Not applicable.

Cited by 11 publications

References 10 publications

Dupilumab unmasking cutaneous T‐cell lymphoma: report of a fatal case

Dupilumab unmasking cutaneous T‐cell lymphoma: report of a fatal case

Atopic Dermatitis with Multiple Comorbidities Treated with Dupilumab. A Case Report and Review of the Literature Regarding the Safety of Dupilumab

Biologics and small molecules treatment for moderate-to-severe atopic dermatitis patients with comorbid conditions and special populations: an Italian perspective

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