RESUMO
Mycosis fungoides (MF) is the most prevalent subtype of primary cutaneous T-cell lymphomas (CTCLs). Sézary syndrome (SS) is another entity defined by leukaemic involvement, lymphadenopathy and erythroderma. Pegylated liposomal doxorubicin (PEG-DOXO) is an anthracycline used in the management of advanced primary CTCL, particularly in induction strategies. However, there are limited data on its effectiveness and tolerability in real-life patients. We report 36 patients who received PEG-DOXO for MF or SS in our centre, describing the patients' characteristics, response rates and tolerance to the treatment. The best overall responses were observed for the skin, with lower response rates for nodal involvement and moderate responses for blood disease. The treatment was mainly well tolerated, without severe adverse events, and no cardiotoxicity was observed on cardiac function monitoring.
Assuntos
Linfoma Cutâneo de Células T , Micose Fungoide , Síndrome de Sézary , Neoplasias Cutâneas , Doxorrubicina/efeitos adversos , Doxorrubicina/análogos & derivados , Humanos , Linfoma Cutâneo de Células T/patologia , Micose Fungoide/tratamento farmacológico , Micose Fungoide/patologia , Polietilenoglicóis , Síndrome de Sézary/tratamento farmacológico , Síndrome de Sézary/patologia , Neoplasias Cutâneas/patologiaAssuntos
Lentigo , Leucemia-Linfoma de Células T do Adulto , Linfoma Cutâneo de Células T , Neoplasias Cutâneas , Humanos , Linfoma Cutâneo de Células T/induzido quimicamente , Linfoma Cutâneo de Células T/diagnóstico , Linfoma Cutâneo de Células T/tratamento farmacológico , Anticorpos Monoclonais Humanizados/efeitos adversos , Neoplasias Cutâneas/induzido quimicamente , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/tratamento farmacológico , Leucemia-Linfoma de Células T do Adulto/patologiaAssuntos
Brentuximab Vedotin , Imunoconjugados , Linfoma Anaplásico de Células Grandes , Antineoplásicos Imunológicos/uso terapêutico , Brentuximab Vedotin/uso terapêutico , Humanos , Imunoconjugados/uso terapêutico , Antígeno Ki-1 , Linfoma Anaplásico de Células Grandes/diagnóstico , Linfoma Anaplásico de Células Grandes/tratamento farmacológico , Linfoma Anaplásico de Células Grandes/patologiaRESUMO
Literature regarding the effect of biologics on the course of mycosis fungoides (MF) is scarce. This multicentre study analysed retrospective data on 19 patients with MF, who were treated with biologics; 12 for inflammatory conditions coexisting with MF, and 7 for MF misdiagnosed as an inflammatory skin disease. Eight patients were treated with anti-tumour necrosis factor-α-monotherapy; 6 had early-stage MF, in 3 patients MF preceded and in 3 MF was diagnosed after initiation of biologics, with no stage-progression or with stable disease, respectively (median treatment time concurrent with MF 57 months). Two patients had advanced stage MF: IIB, treated for 15 months with no stage-progression, and IVA1, treated for 8 months, died of disease 10 months later. The other 11/19 patients received anti-interleukin-17A and/or anti-interleukin-12/23 or anti-interleukin-23 (with/without anti-tumour necrosis factor-α/anti-interleukin-4/13), with stage-progression in 8 patients after a median of 8 months' treatment. Although, in general, biologics should be avoided in patients with MF, these results indicate that anti-tumour necrosis factor-α-monotherapy might not aggravate the disease course in early-stage patients. Interleukin-17A, interleukin-12/23 and interleukin-23 pathway-blockers may prompt progression of MF.
Assuntos
Micose Fungoide , Neoplasias Cutâneas , Citocinas , Humanos , Interleucinas , Micose Fungoide/diagnóstico , Micose Fungoide/tratamento farmacológico , Estudos Retrospectivos , Neoplasias Cutâneas/tratamento farmacológicoAssuntos
Dermatite Alérgica de Contato/etiologia , Resinas Epóxi/efeitos adversos , Vidro , Adulto , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/tratamento farmacológico , Dermatite de Contato , Feminino , Glucocorticoides/uso terapêutico , Humanos , Testes do EmplastroAssuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Psoríase/tratamento farmacológico , Talidomida/análogos & derivados , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/complicações , Leucemia Mielogênica Crônica BCR-ABL Positiva/diagnóstico , Leucemia Mielogênica Crônica BCR-ABL Positiva/imunologia , Masculino , Pessoa de Meia-Idade , Psoríase/complicações , Psoríase/diagnóstico , Psoríase/imunologia , Índice de Gravidade de Doença , Talidomida/uso terapêutico , Resultado do TratamentoAssuntos
Alopecia/induzido quimicamente , Produtos Biológicos/efeitos adversos , Certolizumab Pegol/efeitos adversos , Psoríase/induzido quimicamente , Sacroileíte/tratamento farmacológico , Alopecia/diagnóstico , Alopecia/patologia , Produtos Biológicos/administração & dosagem , Biópsia , Certolizumab Pegol/administração & dosagem , Substituição de Medicamentos , Feminino , Humanos , Pessoa de Meia-Idade , Psoríase/diagnóstico , Psoríase/patologia , Pele/efeitos dos fármacos , Pele/patologia , Ustekinumab/administração & dosagemRESUMO
Bullous pemphigoid (BP) is an acquired autoimmune bullous disease characterized by autoantibodies against the hemidesmosomal proteins found in the basal keratinocytes of the basement membrane zone (BMZ): a 180 kDa protein (type XVII collagen) mainly and the 230 kDa antigen. There is such evidence that the antibodies against the BMZ components are not only of IgG type, but also this bullous disease may have IgE antibodies directed to the BMZ that contribute to the pathogenesis of the disorder. IgE is not only thought to contribute to the pathogenesis of BP, it has also been suggested that eosinophils play a role in the development of the first signs associated with BP. A humanized monoclonal antibody directed to IgE, omalizumab, is approved for the treatment of severe asthma and chronic spontaneous urticaria, and it may be useful in the treatment of BP in the first stages of the disease.