Treatment of CD30-Negative Refractory Mycosis Fungoides With Brentuximab Vedotin

Zhang, Connie; Chairatchaneeboon, Manasmon; Haun, Paul; Landsburg, Daniel J.; Kim, Ellen J.

doi:10.1001/jamadermatol.2017.3961

Cited by 18 publications

(13 citation statements)

References 6 publications

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“…Moreover, in the literature, a total of 13 cases highlight the potential efficacy of BV in MF with < 10% CD30 + lymphoid cells. We further note that response to BV has been observed in patients with a low expression of CD30, along with < 1% CD30 expression . Nevertheless, conflicting results have been found by Kim et al .…”

Section: Discussionsupporting

confidence: 47%

“…We further note that response to BV has been observed in patients with a low expression of CD30, along with < 1% CD30 expression. [7][8][9] Nevertheless, conflicting results have been found by Kim et al in their phase II study of BV, with a significantly lower likelihood of global response in the patients with < 5% CD30 expression. 10 The reason for the efficacy of BV in MF with a negative or low expression of CD30 is still unknown.…”

Section: Discussionmentioning

confidence: 98%

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Dramatic response to brentuximab vedotin in refractory nontransformed CD 30 ^– mycosis fungoides allowing allogeneic stem cell transplant and long‐term complete remission

Mahévas¹,

Ram‐Wolff²,

Battistella

et al. 2019

Br J Dermatol

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Summary The erythrodermic ulcerated form of mycosis fungoides (MF) is exceptional, and treatment of refractory cases is challenging. Brentuximab vedotin (BV) is a monoclonal antibody combined with monomethyl auristatin E, recently approved for the treatment of refractory CD30+ cutaneous T‐cell lymphoma. We report a case of refractory MF in a 56‐year‐old man with a long history of large‐plaque parapsoriasis, as revealed by psoriasiform erythroderma, treated initially with cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) polychemotherapy, inducing a 2‐year complete response. After relapse, interferon and gemcitabine were unsuccessful. Finally, treatment with BV was decided upon, despite the absence of CD30 expression. After three infusions of BV 1·8 mg kg−1, we achieved a complete and stable response, allowing an allogeneic stem cell transplant. The patient is still in complete remission, 19 months after the graft. This case illustrates the possibility of using BV in refractory CD30– MF as a salvage therapy.

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Section: Discussionsupporting

confidence: 47%

Section: Discussionmentioning

confidence: 98%

Dramatic response to brentuximab vedotin in refractory nontransformed CD 30 ^– mycosis fungoides allowing allogeneic stem cell transplant and long‐term complete remission

Mahévas¹,

Ram‐Wolff²,

Battistella

et al. 2019

Br J Dermatol

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“…In this report, we present a patient with CD30‐negative MF who demonstrated a dramatic response to brentuximab. Two similar cases have been published in the literature (Mahevas et al, ; Zhang, Chairatchaneeboon, Haun, Landsburg, & Kim, ).…”

supporting

confidence: 60%

Impressive response of CD30‐negative, treatment‐refractory mycosis fungoides to brentuximab vedotin

Goyal

Hordinsky

Lazaryan

2019

Dermatologic Therapy

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Brentuximab vedotin is a CD30‐antibody/drug conjugate which has demonstrated excellent response in treating CD30‐positive mycosis fungoides (MF) and anaplastic large cell lymphoma (ALCL). In this report, we present a patient with CD30‐negative MF refractory to multiple other lines of therapy who demonstrated a dramatic response to brentuximab. This paradoxical response may be due to inadequate detection of CD30 expression by immunohistochemical techniques. From this case we see that even in the setting of apparent CD30 negativity, brentuximab may be a viable treatment option for patients who require bridging to stem cell transplant or seek successful palliation. This case highlights the point that rigid inclusion criteria for MF trials without use of more sensitive techniques to confirm lack of CD30 expression may inappropriate.

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“…This could explain why PCR tests are mostly negative in patients with suspected COVID-19 chilblains. 4 Battesti and Descamps reported that patients with moderately severe COVID-19 had high circulating levels of IFN-1. 4 We hypothesize that in young adults with efficient innate immune responses, the IFN-1 pathway inhibits the replication of SARS-CoV-2 and dampens the symptoms of COVID-19.…”

mentioning

confidence: 99%

“…4 Battesti and Descamps reported that patients with moderately severe COVID-19 had high circulating levels of IFN-1. 4 We hypothesize that in young adults with efficient innate immune responses, the IFN-1 pathway inhibits the replication of SARS-CoV-2 and dampens the symptoms of COVID-19. In parallel, activation of the IFN-1 pathway might lead to manifestations that have been already described in interferonopathies like lupus (i.e.…”

mentioning

confidence: 99%

Most rare subtypes of cutaneous lymphoma display variable CD30 expression: analysis of the German Cutaneous Lymphoma Network

et al. 2021

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coding for the IFN-induced Mx protein in skin biopsies from patients with chilblains. 4 The Mx protein sequesters viral factors required for viral replication. 6 Furthermore, an IFN-induced transmembrane protein may inhibit coronavirus replication. This could explain why PCR tests are mostly negative in patients with suspected COVID-19 chilblains. 4 Battesti and Descamps reported that patients with moderately severe COVID-19 had high circulating levels of IFN-1. 4 We hypothesize that in young adults with efficient innate immune responses, the IFN-1 pathway inhibits the replication of SARS-CoV-2 and dampens the symptoms of COVID-19. In parallel, activation of the IFN-1 pathway might lead to manifestations that have been already described in interferonopathies like lupus (i.e. chilblains). The inhibition of viral replication might explain the negative RT-PCR and serological test results in the present case.To conclude, we report on a case of recurrent chilblains, the appearances of which coincided with the epidemic peaks in France and contact with a SARS-CoV-2-positive close relative. Our observation reinforces the hypothesis of a causal relationship between SARS-CoV-2 infection and chilblains. It also raises the question of whether this manifestation is likely to occur or recur during contact with SARS-CoV-2 components (e.g. during a mass vaccination campaign).

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Treatment of CD30-Negative Refractory Mycosis Fungoides With Brentuximab Vedotin

Cited by 18 publications

References 6 publications

Dramatic response to brentuximab vedotin in refractory nontransformed CD 30 ^– mycosis fungoides allowing allogeneic stem cell transplant and long‐term complete remission

Dramatic response to brentuximab vedotin in refractory nontransformed CD 30 ^– mycosis fungoides allowing allogeneic stem cell transplant and long‐term complete remission

Impressive response of CD30‐negative, treatment‐refractory mycosis fungoides to brentuximab vedotin

Most rare subtypes of cutaneous lymphoma display variable CD30 expression: analysis of the German Cutaneous Lymphoma Network

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Treatment of CD30-Negative Refractory Mycosis Fungoides With Brentuximab Vedotin

Cited by 18 publications

References 6 publications

Dramatic response to brentuximab vedotin in refractory nontransformed CD 30 – mycosis fungoides allowing allogeneic stem cell transplant and long‐term complete remission

Dramatic response to brentuximab vedotin in refractory nontransformed CD 30 – mycosis fungoides allowing allogeneic stem cell transplant and long‐term complete remission

Impressive response of CD30‐negative, treatment‐refractory mycosis fungoides to brentuximab vedotin

Most rare subtypes of cutaneous lymphoma display variable CD30 expression: analysis of the German Cutaneous Lymphoma Network

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Dramatic response to brentuximab vedotin in refractory nontransformed CD 30 ^– mycosis fungoides allowing allogeneic stem cell transplant and long‐term complete remission

Dramatic response to brentuximab vedotin in refractory nontransformed CD 30 ^– mycosis fungoides allowing allogeneic stem cell transplant and long‐term complete remission