Stage IV CD30+ anaplastic large cell lymphoma: response to acitretin and interferon-alpha.
Retinoids and interferon (IFN)-alpha induce differentiation, affect cell proliferation and alter various immune parameters. In combination, their effects may be additive or even synergistic in the treatment of malignancy. We present a 53-year-old woman with stage IV CD30+ anaplastic large cell lymphoma with brain, lung and skin involvement. The patient had been on methotrexate for rheumatoid arthritis. After a combination of oral acitretin 50 mg daily and IFN-alpha 3 million units subcutaneously 3 times per week, the skin lesions cleared within 2 months, lung lesions by 5 months and brain lesions by 7 months. Although we cannot exclude that methotrexate played a role in the development of this lymphoma and that its withdrawal contributed to the clearance of lesions, we propose that the patient's disease responded to the combination of acitretin and IFN-alpha.
Ong
Colin
C
Department of Dermatology, Westmead Hospital, Westmead, New South Wales, Australia. c_s__ong@hotmail.com
Sullivan
John
J
Hertzberg
Mark
M
Stapleton
Karen
K
D017255:Acitretin / Q000008:administration & dosage*; D000284:Administration, Oral; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001132:Arm; D001707:Biopsy, Needle; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007262:Infusions, Intravenous; D016898:Interferon-alpha / Q000008:administration & dosage*; D007641:Keratolytic Agents / Q000008:administration & dosage; D017730:Ki-1 Antigen / Q000032:analysis; D017728:Lymphoma, Large-Cell, Anaplastic / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009367:Neoplasm Staging; D012883:Skin Ulcer / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D016898:Interferon-alpha; D007641:Keratolytic Agents; D017730:Ki-1 Antigen; D017255:Acitretin