Melanoma and rituximab: an incidental association?
Rituximab is an anti-CD20 monoclonal antibody increasingly used in haematology and rheumatology, but also in internal medicine and dermatology. It has a good tolerance profile without known increased risk of cancer. We report a case of nodular melanoma with a 4.8 mm Breslow thickness that appeared after 2 years of rituximab in a 45-year-old patient with non-Hodgkin lymphoma. Fifteen additional rituximab-associated melanoma cases in 13 patients have been identified in the literature and in the EudraVigilance database. These patients were treated for various indications and had melanomas, often aggressive, initially diagnosed at a metastatic stage in 31% of cases. Our work raises the question of rituximab accountability in melanoma onset in these immunosuppressed patients. A dermatological monitoring seems necessary in patients treated with rituximab, especially in case of risk factors for melanoma. In case of individual melanoma history, the benefit/risk ratio of initiating rituximab therapy should be carefully assessed.
Department of Dermato-Cancerology, Nantes University Hospital, INSERM U892-CNRS U6299, CIC Biothérapie INSERM 0503, Nantes, France.
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Brocard
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Saint-Jean
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Batz
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Jolliet
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Dréno
D058846:Antibodies, Monoclonal, Murine-Derived / Q000009:adverse effects* / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000556:secondary*; D001932:Brain Neoplasms / Q000556:secondary*; D006258:Head and Neck Neoplasms / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects* / Q000627:therapeutic use; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy; D008297:Male; D008545:Melanoma / Q000139:chemically induced* / Q000556:secondary / Q000601:surgery; D008875:Middle Aged; D060735:Pharmacovigilance; D000069283:Rituximab; D012535:Scalp / Q000601:surgery; D012878:Skin Neoplasms / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery
D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab