title: Treatment of cutaneous T-cell lymphoma with oral alitretinoin.
abstract: BACKGROUND
  Cutaneous T-cell lymphoma (CTCL) is a potentially life-limiting malignant disease. Treatment strategies in CTCL aim at disease control and remission with the lowest possible side-effects.
  
  
  OBJECTIVE
  Recent reports suggest that the new vitamin A derivative alitretinoin might be a well-tolerated treatment option.
  
  
  METHODS
  We analysed the files of 11 CTCL patients with mycosis fungoides (n = 10) or Sézary syndrome (n = 1), who were treated with oral alitretinoin alone or in combination with standard treatment based on individual off-label treatment decisions. Patients had been monitored every 4-8 weeks with skin examination and laboratory analyses.
  
  
  RESULTS
  Ten of 11 patients (90.9%) showed a marked improvement of their CTCL skin lesions and no progress of the disease during treatment with alitretinoin, one patient showed no response to the treatment (9.1%). Four of the responding patients (40.0%) had a complete response and 6 (60.0%) had a partial response. Average time to response was 2.5 months. Duration of treatment varied depending on whether patients had reached complete or partial remission. In general, alitretinoin was well tolerated. One of 11 patients developed high non-fasting average serum cholesterol (>300 mg/dL) and 1/11 a mean non-fasting triglyceride value >500 mg/dL. In 3/11 patients, thyroid-stimulating hormone declined without clinical symptoms during treatment, with one of the patients also showing a decreased thyroxin level.
  
  
  CONCLUSIONS
  In our group of CTCL patients we noticed a low rate of side-effects and an overall good clinical response to treatment with alitretinoin. Further studies are required to substantiate this early clinical observation.
authors.affiliation: Department of Dermatology and Allergy, Ludwig Maximilian University, Munich, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Kapser
authors.forename: T
authors.initials: T
authors.lastname: Herzinger
authors.forename: T
authors.initials: T
authors.lastname: Ruzicka
authors.forename: M
authors.initials: M
authors.lastname: Flaig
authors.forename: S
authors.initials: S
authors.lastname: Molin
mesh_terms: D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000077556:Alitretinoin; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D065095:Calcineurin Inhibitors / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000188:drug therapy* / Q000473:pathology; D056687:Off-Label Use; D011701:PUVA Therapy; D017893:Photopheresis; D019233:Retreatment; D012189:Retrospective Studies; D012751:Sezary Syndrome / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome; D014212:Tretinoin / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000305:Adrenal Cortex Hormones; D000970:Antineoplastic Agents; D065095:Calcineurin Inhibitors; D000077556:Alitretinoin; D014212:Tretinoin