Ten-year experience of bexarotene therapy for cutaneous T-cell lymphoma in Finland.
Bexarotene is an oral retinoid shown to be active against the cutaneous manifestations of cutaneous T-cell lym-phoma (CTCL). Literature on the efficacy, dosing and side-effects of bexarotene is sparse. We present here data on 37 Finnish patients with CTCL treated with bexarotene during the last 10 years. Bexarotene was equally effective as monotherapy or when combined with other treatment modalities, resulting in overall responses of approximately 75%. Early-stage CTCL responded better than advanced-stage CTCL (83% vs. 33%). The mean time to observable response was 3 months and the mean duration of the response was 21 months. The dose of bexarotene was generally lower than recommended due to side-effects. Abrupt elevation of liver transaminases, resulting in cessation of treatment, was observed in 4 (11%) patients. We conclude that the dose of bexarotene should be titrated individually to achieve optimal results. Maintenance therapy with low-dose bexarotene is a feasible alternative.
Department of Dermatology and Allergology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland. liisa.vakeva@hus.fi
Liisa
L
Väkevä
Annamari
A
Ranki
Sonja
S
Hahtola
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D016588:Anticarcinogenic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001219:Aspartate Aminotransferases / Q000097:blood; D000077610:Bexarotene; D003131:Combined Modality Therapy; D005387:Finland; D006801:Humans; D006937:Hypercholesterolemia / Q000139:chemically induced; D015228:Hypertriglyceridemia / Q000139:chemically induced; D007037:Hypothyroidism / Q000139:chemically induced; D008099:Liver / Q000201:enzymology / Q000503:physiopathology; D016410:Lymphoma, T-Cell, Cutaneous / Q000188:drug therapy* / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D009503:Neutropenia / Q000139:chemically induced; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D013764:Tetrahydronaphthalenes / Q000009:adverse effects / Q000627:therapeutic use*
D016588:Anticarcinogenic Agents; D013764:Tetrahydronaphthalenes; D000077610:Bexarotene; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase