Dupilumab-associated mycosis fungoides: a cross-sectional study.
Atopic dermatitis
Dupilumab
Mycosis fungoides
Sezary syndrome
Journal
Archives of dermatological research
ISSN: 1432-069X
Titre abrégé: Arch Dermatol Res
Pays: Germany
ID NLM: 8000462
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
received:
24
07
2022
accepted:
24
05
2023
revised:
13
04
2023
medline:
22
9
2023
pubmed:
4
6
2023
entrez:
4
6
2023
Statut:
ppublish
Résumé
Treating atopic dermatitis (AD) with dupilumab, a monoclonal antibody that inhibits interleukin-4 (IL-4) and interleukin-13 (IL-13), may be associated with the progression of mycosis fungoides (MF).This study aims to examine the associations between the length of dupilumab treatment, age and sex, and the onset of MF.An institutional data registry and literature search were used for a retrospective cross-sectional study. Only patients with a diagnosis of MF on dupilumab for the treatment of AD and eczematous dermatitis were included.The primary outcome was the length of dupilumab exposure, age, sex, and the onset of MF. Linear correlations (Pearson) and Cox regression analysis were used to assess the correlation and the risk.A total of 25 patients were included in this study. Five eligible patients were identified at our institution. In addition, a PubMed review identified an additional 20 patients. At the time of MF diagnosis, the median age was 58, with 42% female. Disease history was significant for adult-onset AD in most patients (n = 17, 65.4%) or recent flare of AD previously in remission (n = 3, 11.5%). All patients were diagnosed with MF, and one patient progressed to Sézary syndrome while on dupilumab, with an average duration of 13.5 months of therapy prior to diagnosis. Tumor stage at diagnosis of MF was described in 19 of the cases and ranged from an early-stage disease (IA) to advanced disease (IV). Treatment strategies included narrow-band UVB therapy, topical corticosteroids, brentuximab, pralatrexate, and acitretin. Male gender, advanced-stage disease, and older age correlated significantly with the hazard of MF onset and a shorter time to onset during dupilumab treatment.Our results suggest a correlation between the duration of dupilumab treatment and the diagnosis of MF, the higher MF stage at diagnosis, and the shorter the duration of using dupilumab to MF onset. Furthermore, elderly male patients appeared to be more at risk as both male gender and older age correlated with a hazard of MF diagnosis. The results raise the question as to whether the patients had MF misdiagnosed as AD that was unmasked by dupilumab or if MF truly is an adverse effect of treatment with dupilumab. Close monitoring of these patients and further investigation of the relationship between dupilumab and MF can shed more light on this question .
Identifiants
pubmed: 37270763
doi: 10.1007/s00403-023-02652-z
pii: 10.1007/s00403-023-02652-z
doi:
Substances chimiques
dupilumab
420K487FSG
Antibodies, Monoclonal
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2561-2569Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Silverberg JI, Kantor R (2017) The role of interleukins 4 and/or 13 in the pathophysiology and treatment of atopic dermatitis. Dermatol Clin 35(3):327–334
doi: 10.1016/j.det.2017.02.005
pubmed: 28577802
Amorim GM, Niemeyer-Corbellini JP, Quintella DC, Cuzzi T, Ramos-E-Silva M (2018) Clinical and epidemiological profile of patients with early stage mycosis fungoides. An Bras Dermatol 93(4):546–552
doi: 10.1590/abd1806-4841.20187106
pubmed: 30066762
pmcid: 6063099
Saulite I, Hoetzenecker W, Weidinger S, Cozzio A, Guenova E, Wehkamp U (2016) Sézary syndrome and atopic dermatitis: comparison of immunological aspects and targets. Biomed Res Int 2016:9717530
doi: 10.1155/2016/9717530
pubmed: 27294147
pmcid: 4886049
Ayasse M, Nelson K, Glass F, Silverberg JI (2021) Mycosis fungoides unmasked by dupilumab treatment in a patient with a history of atopic dermatitis. Dermatitis 32(1S):e88–e89
doi: 10.1097/DER.0000000000000679
pubmed: 33273230
Espinosa ML, Nguyen MT, Aguirre AS et al (2020) Progression of cutaneous T-cell lymphoma after dupilumab: case review of 7 patients. J Am Acad Dermatol 83(1):197–199
doi: 10.1016/j.jaad.2020.03.050
pubmed: 32229275
pmcid: 7302979
Kelati A, Gallouj S, Tahiri L, Harmouche T, Mernissi FZ (2017) Defining the mimics and clinico-histological diagnosis criteria for mycosis fungoides to minimize misdiagnosis. Int J Womens Dermatol 3(2):100–106
doi: 10.1016/j.ijwd.2016.11.006
pubmed: 28560304
pmcid: 5440453
Willemze R, Cerroni L, Kempf W et al (2019) The 2018 update of the WHO-EORTC classification for primary cutaneous lymphomas. Blood 133(16):1703–1714
doi: 10.1182/blood-2018-11-881268
pubmed: 30635287
pmcid: 6473500
IBM Corp. Released 2020. IBM SPSS Statistics for windows, version 27.0. Armonk, NY: IBM Corp.
Chiba T, Nagai T, Osada SI, Manabe M (2019) Diagnosis of mycosis fungoides following administration of dupilumab for misdiagnosed atopic dermatitis. Acta Derm Venereol 99(9):818–819
doi: 10.2340/00015555-3208
pubmed: 31045233
Newsom M, Hrin ML, Hamid RN, et al. (2021) Two cases of mycosis fungoides diagnosed after treatment non-response to dupilumab. Dermatol Online J. 27(1). https://www.ncbi.nlm.nih.gov/pubmed/33560800
Russomanno K, Carver DeKlotz CM (2021) Acceleration of cutaneous T-cell lymphoma following dupilumab administration. JAAD Case Rep 8:83–85
doi: 10.1016/j.jdcr.2020.12.010
pubmed: 33532533
Miyashiro D, Vivarelli AG, Gonçalves F, Cury-Martins J, Sanches JA (2020) Progression of mycosis fungoides after treatment with dupilumab: a case report. Dermatol Ther 33(6):e13880
doi: 10.1111/dth.13880
pubmed: 32558148
Hollins LC, Wirth P, Fulchiero GJ Jr, Foulke GT (2020) Long-standing dermatitis treated with dupilumab with subsequent progression to cutaneous T-cell lymphoma. Cutis 106(2):E8–E11
doi: 10.12788/cutis.0074
pubmed: 32941565
Sokumbi O, Shamim H, Davis MDP, Wetter DA, Newman CC, Comfere N (2021) Evolution of Dupilumab-associated cutaneous atypical lymphoid infiltrates. Am J Dermatopathol 43(10):714–720
doi: 10.1097/DAD.0000000000001875
pubmed: 34132660
Sanches JA, Cury-Martins J, Abreu RM, Miyashiro D, Pereira J (2021) Mycosis fungoides and sézary syndrome: focus on the current treatment scenario. An Bras Dermatol 96(4):458–471
doi: 10.1016/j.abd.2020.12.007
pubmed: 34053802
pmcid: 8245718
Peñate Y, Servitje O, Machan S et al (2018) The first year of the AEVD primary cutaneous lymphoma registry. Actas Dermosifiliogr 109(7):610–616
doi: 10.1016/j.ad.2018.03.006
pubmed: 29680323
Pulitzer M (2017) Cutaneous T-cell lymphoma. Clin Lab Med. 37(3):527–546
doi: 10.1016/j.cll.2017.06.006
pubmed: 28802499
pmcid: 5710803
Bradford PT, Devesa SS, Anderson WF, Toro JR (2009) Cutaneous lymphoma incidence patterns in the United States: a population-based study of 3884 cases. Blood 113(21):5064–5073
doi: 10.1182/blood-2008-10-184168
pubmed: 19279331
pmcid: 2686177
Lambert WC, Cohen PJ, Schwartz RA (1997) Surgical management of mycosis fungoides. J Med 28(3–4):211–222
pubmed: 9355025
García-Díaz N, Piris MÁ, Ortiz-Romero PL, Vaqué JP (2021) Mycosis fungoides and sézary syndrome: an integrative review of the pathophysiology, molecular drivers, and targeted therapy. Cancers. https://doi.org/10.3390/cancers13081931
doi: 10.3390/cancers13081931
pubmed: 33923722
pmcid: 8074086
Gooderham MJ, Hong HCH, Eshtiaghi P, Papp KA (2018) Dupilumab: a review of its use in the treatment of atopic dermatitis. J Am Acad Dermatol 78(3 Suppl 1):S28–S36
doi: 10.1016/j.jaad.2017.12.022
pubmed: 29471919
Hengge UR, Ruzicka T, Schwartz RA, Cork MJ (2006) Adverse effects of topical glucocorticosteroids. J Am Acad Dermatol. 54(1):1–15 (quiz 16-18)
doi: 10.1016/j.jaad.2005.01.010
pubmed: 16384751
Na CH, Chung J, Simpson EL (2019) Quality of life and disease impact of atopic dermatitis and psoriasis on children and their families. Children. https://doi.org/10.3390/children6120133
doi: 10.3390/children6120133
pubmed: 31810362
pmcid: 6955769
Mollanazar NK, Savage KT, Pousti BT et al (2020) Cutaneous T-cell lymphoma and concomitant atopic dermatitis responding to dupilumab. Cutis 106(3):131–132
doi: 10.12788/cutis.0066
pubmed: 33104116
Lazaridou I, Ram-Wolff C, Bouaziz JD et al (2020) Dupilumab treatment in two patients with cutaneous T-cell lymphomas. Acta Derm Venereol. 100(16):adv00271
doi: 10.2340/00015555-3576
pubmed: 32556342
Geskin LJ, Viragova S, Stolz DB, Fuschiotti P (2015) Interleukin-13 is overexpressed in cutaneous T-cell lymphoma cells and regulates their proliferation. Blood 125(18):2798–2805
doi: 10.1182/blood-2014-07-590398
pubmed: 25628470
pmcid: 4424628
Burg G, Dummer R, Haeffner A, Kempf W, Kadin M (2001) From inflammation to neoplasia: mycosis fungoides evolves from reactive inflammatory conditions (lymphoid infiltrates) transforming into neoplastic plaques and tumors. Arch Dermatol 137(7):949–952
pubmed: 11453817
Nakazaki K, Yoshida M, Masamoto Y et al (2022) Discordant lymphomas of classic hodgkin lymphoma and peripheral T-cell lymphoma following dupilumab treatment for atopic dermatitis. Int J Hematol. https://doi.org/10.1007/s12185-022-03330-y
doi: 10.1007/s12185-022-03330-y
pubmed: 35355217
Amagai M, Ozawa M, Amagai R et al (2022) Nodal anaplastic large cell lymphoma with lymphomatoid papulosis following treatment of initially presumed atopic dermatitis with dupilumab: a case report. Dermatol Ther 35(3):e15290
doi: 10.1111/dth.15290
pubmed: 34962024
Olsen E, Vonderheid E, Pimpinelli N et al (2007) Revisions to the staging and classification of mycosis fungoides and sezary syndrome: a proposal of the international society for cutaneous lymphomas (ISCL) and the cutaneous lymphoma task force of the European organization of research and treatment of cancer (EORTC). Blood 110(6):1713–1722
doi: 10.1182/blood-2007-03-055749
pubmed: 17540844
Smith GL, Wilson LD, Dabaja BS (2016) Chapter 79 Mycosis Fungoides. In: Gunderson LL, Tepper JE (eds) Clinical radiation oncology (Fourth Edition), 4th edn. Elsevier, pp 1556-1576.e4