Low-dose Methotrexate Treatment for Solitary or Localized Primary Cutaneous Anaplastic Large Cell Lymphoma: A Long-term Follow-up Study

Overview

Journal Acta Derm Venereol

Specialty Dermatology

Date 2020 Jan 31

PMID 31996929

Citations 1

Authors

Jong Bin Park

Myeong Hyeon Yang

Do Ik Kwon

Seol Hwa Seong

Ji Yun Jang

Kee Suck Suh

Min Soo Jang

Affiliations

Soon will be listed here.

Abstract

Although low-dose methotrexate (MTX) has been used widely in treatment of a variety of dermatological diseases, including multifocal primary cutaneous anaplastic large cell lymphoma (PCALCL), it has not been established for use in the treatment guidelines for solitary or localized PCALCL. Furthermore, there has been no report of long-term follow-up data in Asian patients with PCALCL treated with low-dose MTX. To investigate the effectiveness and clinical outcome of treatment with low-dose MTX, clinical and long-term follow-up data of 7 patients with solitary or localized PCALCL were analysed retrospectively. Of the 7 patients, 6 (85.7%) showed a complete response and 1 (14.3%) showed partial remission. During follow-up, mean duration of 92.1 months, 5 patients developed one or more cutaneous relapses. At the last follow-up, all of the patients with PCALCL were alive without disease. These results indicate that low-dose MTX is a highly effective and safe treatment for solitary or localized PCALCL as well as multiple relapsed lesions.

Citing Articles

Primary Cutaneous Anaplastic Large Cell Lymphoma Arising in a Patient with Rhupus Syndrome and Sjogren's Syndrome.

Gao Z, Xu Q, Chen X, Mao D, Zhang J, Jin J Clin Cosmet Investig Dermatol. 2022; 15:975-979.

PMID: 35669086 PMC: 9166399. DOI: 10.2147/CCID.S366789.

References

Didona B, Benucci R, Amerio P, Canzona F, Rienzo O, Cavalieri R . Primary cutaneous CD30+ T-cell lymphoma responsive to topical imiquimod (Aldara). Br J Dermatol. 2004; 150(6):1198-201. DOI: 10.1111/j.1365-2133.2004.05993.x. View

Bekkenk M, Geelen F, van Voorst Vader P, Heule F, Geerts M, van Vloten W . Primary and secondary cutaneous CD30(+) lymphoproliferative disorders: a report from the Dutch Cutaneous Lymphoma Group on the long-term follow-up data of 219 patients and guidelines for diagnosis and treatment. Blood. 2000; 95(12):3653-61. View

Kempf W, Pfaltz K, Vermeer M, Cozzio A, Ortiz-Romero P, Bagot M . EORTC, ISCL, and USCLC consensus recommendations for the treatment of primary cutaneous CD30-positive lymphoproliferative disorders: lymphomatoid papulosis and primary cutaneous anaplastic large-cell lymphoma. Blood. 2011; 118(15):4024-35. PMC: 3204726. DOI: 10.1182/blood-2011-05-351346. View

Oschlies I, Lisfeld J, Lamant L, Nakazawa A, DAmore E, Hansson U . ALK-positive anaplastic large cell lymphoma limited to the skin: clinical, histopathological and molecular analysis of 6 pediatric cases. A report from the ALCL99 study. Haematologica. 2012; 98(1):50-6. PMC: 3533659. DOI: 10.3324/haematol.2012.065664. View

Yokoi I, Ishikawa E, Koura A, Hosokawa Y, Tamai A, Nakai K . Successful treatment of primary cutaneous anaplastic large cell lymphoma with intralesional methotrexate therapy. Acta Derm Venereol. 2013; 94(3):319-20. DOI: 10.2340/00015555-1692. View

Fauconneau A, Pham-Ledard A, Cappellen D, Frison E, Prochazkova-Carlotti M, Parrens M . Assessment of diagnostic criteria between primary cutaneous anaplastic large-cell lymphoma and CD30-rich transformed mycosis fungoides; a study of 66 cases. Br J Dermatol. 2015; 172(6):1547-1554. DOI: 10.1111/bjd.13690. View

Fujita H, Nagatani T, Miyazawa M, Wada H, Koiwa K, Komatsu H . Primary cutaneous anaplastic large cell lymphoma successfully treated with low-dose oral methotrexate. Eur J Dermatol. 2008; 18(3):360-1. DOI: 10.1684/ejd.2008.0420. View

Prince H, Kim Y, Horwitz S, Dummer R, Scarisbrick J, Quaglino P . Brentuximab vedotin or physician's choice in CD30-positive cutaneous T-cell lymphoma (ALCANZA): an international, open-label, randomised, phase 3, multicentre trial. Lancet. 2017; 390(10094):555-566. DOI: 10.1016/S0140-6736(17)31266-7. View

Newland K, McCormack C, Twigger R, Buelens O, Hughes C, Lade S . The efficacy of methotrexate for lymphomatoid papulosis. J Am Acad Dermatol. 2015; 72(6):1088-90. DOI: 10.1016/j.jaad.2015.03.001. View

10.

Lee J, Cheng A, Lin C, Kuo S . Multifocal primary cutaneous CD30+ anaplastic large cell lymphoma responsive to thalidomide: the molecular mechanism and the clinical application. Br J Dermatol. 2009; 160(4):887-9. DOI: 10.1111/j.1365-2133.2009.09042.x. View

11.

Vonderheid E, Sajjadian A, Kadin M . Methotrexate is effective therapy for lymphomatoid papulosis and other primary cutaneous CD30-positive lymphoproliferative disorders. J Am Acad Dermatol. 1996; 34(3):470-81. DOI: 10.1016/s0190-9622(96)90442-9. View

12.

Liu H, Hoppe R, Kohler S, Harvell J, Reddy S, Kim Y . CD30+ cutaneous lymphoproliferative disorders: the Stanford experience in lymphomatoid papulosis and primary cutaneous anaplastic large cell lymphoma. J Am Acad Dermatol. 2003; 49(6):1049-58. DOI: 10.1016/s0190-9622(03)02484-8. View

13.

Bruijn M, Horvath B, van Voorst Vader P, Willemze R, Vermeer M . Recommendations for treatment of lymphomatoid papulosis with methotrexate: a report from the Dutch Cutaneous Lymphoma Group. Br J Dermatol. 2015; 173(5):1319-22. DOI: 10.1111/bjd.13920. View

14.

Savage K, Lee Harris N, Vose J, Ullrich F, Jaffe E, Connors J . ALK- anaplastic large-cell lymphoma is clinically and immunophenotypically different from both ALK+ ALCL and peripheral T-cell lymphoma, not otherwise specified: report from the International Peripheral T-Cell Lymphoma Project. Blood. 2008; 111(12):5496-504. DOI: 10.1182/blood-2008-01-134270. View

15.

French L, Shapiro M, Vittorio C, Rook A . Regression of multifocal, skin-restricted, CD30-positive large T-cell lymphoma with interferon alfa and bexarotene therapy. J Am Acad Dermatol. 2001; 45(6):914-8. DOI: 10.1067/mjd.2001.117519. View

16.

Vergier B, de Muret A, Beylot-Barry M, Vaillant L, Ekouevi D, Chene G . Transformation of mycosis fungoides: clinicopathological and prognostic features of 45 cases. French Study Group of Cutaneious Lymphomas. Blood. 2000; 95(7):2212-8. View

17.

Melchers R, Willemze R, Bekkenk M, de Haas E, Horvath B, van Rossum M . Evaluation of treatment results in multifocal primary cutaneous anaplastic large cell lymphoma: report of the Dutch Cutaneous Lymphoma Group. Br J Dermatol. 2018; 179(3):724-731. DOI: 10.1111/bjd.16501. View

18.

Willemze R, Cerroni L, Kempf W, Berti E, Facchetti F, Swerdlow S . The 2018 update of the WHO-EORTC classification for primary cutaneous lymphomas. Blood. 2019; 133(16):1703-1714. PMC: 6473500. DOI: 10.1182/blood-2018-11-881268. View

19.

Demierre M, Goldberg L, Kadin M, Koh H . Is it lymphoma or lymphomatoid papulosis?. J Am Acad Dermatol. 1997; 36(5 Pt 1):765-72. DOI: 10.1016/s0190-9622(97)80330-1. View

20.

Woodruff R, Sangueza O . Response of CD30+ large cell lymphoma of skin to bexarotene. Leuk Lymphoma. 2002; 43(5):1153-4. DOI: 10.1080/10428190290021425. View