The treatment of cutaneous T-cell lymphoma with a novel retinoid.
The clinical experience with bexarotene for cutaneous T-cell lymphoma (CTCL) at our center is reviewed here. Disease activity assessment was monitored every 4 weeks in all patients. Five target lesions were monitored, an area score was performed, and a CTCL-specific health assessment questionnaire was administered. Four patients with refractory plaque CTCL were treated with bexarotene gel. All target lesions disappeared after 8 weeks of therapy, with recurrences observed in untreated areas. In the follow-up period, no recurrences of the original target lesions were observed. One patient withdrew from the study. Patients with refractory patch/plaque disease were randomized to a high-dose (300 mg/m(2)) or low-dose (6.5 mg/m(2)) daily oral regimen of bexarotene. After showing disease progression, the two patients on the low-dose arm were entered into the high-dose arm after 8 weeks. Marked clinical responses were seen in all patients treated. The target lesions showed either complete disappearance or a reduction in lesion size, duration, and scale. No new lesions were noted in patients on high-dose bexarotene. Self-assessments also confirmed the palliative properties of the observed responses. All patients had hypertriglyceridemia despite the concomitant administration of atorvastatin at 60 mg/day. Dose reductions were required to maintain safe lipid levels. Four patients with erythrodermic CTCL were treated with high-dose oral therapy, and all patients showed rapid (within 2 weeks) improvement of erythroderma and symptoms.
Heald
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Department of Dermatology, Yale University School of Medicine, New Haven, CT 06520, USA. peter.heald@yale.edu
D000284:Administration, Oral; D000287:Administration, Topical; D016588:Anticarcinogenic Agents / Q000627:therapeutic use*; D000077610:Bexarotene; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D016410:Lymphoma, T-Cell, Cutaneous / Q000188:drug therapy*; D012878:Skin Neoplasms / Q000188:drug therapy*; D013764:Tetrahydronaphthalenes / Q000627:therapeutic use*
D016588:Anticarcinogenic Agents; D007155:Immunologic Factors; D013764:Tetrahydronaphthalenes; D000077610:Bexarotene