Mogamulizumab-induced interface dermatitis drug rash treated successfully with methotrexate and extracorporeal photopheresis in a patient with Sézary syndrome.
Mogamulizumab-induced interface dermatitis drug rash treated successfully with methotrexate and extracorporeal photopheresis in a patient with Sézary syndrome.
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1例Sézary综合征患者接受甲氨蝶呤和体外血液分离成功治疗莫格木单抗诱导的界面皮炎药物皮疹。
DOI：
10.1016/j.jdcr.2020.12.035
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发表时间：
2021-03
影响因子：
--
通讯作者：
Mangold AR
中科院分区：
文献类型：
--
作者：
Breen ID;Brumfiel CM;Patel MH;Rosenthal AC;Rule WG;DiCaudo DJ;Craig FE;Pittelkow MR;Mangold AR
Sézary综合征（SS）的定义是红皮病，外周血中存在循环恶性T细胞和全身性淋巴结病。SS与低或高疾病负荷相关，取决于是否存在小于或大于5000/μL的循环恶性细胞。1高风险疾病需要更积极的治疗，包括体外循环血液置换术（ECP）、干扰素或贝沙罗汀的联合治疗，或罗米地辛或莫加木利珠单抗的单药治疗。莫加木利珠单抗已被美国食品和药物管理局批准用于治疗复发性或难治性蕈样肉芽肿（MF）或SS，在至少一个先前的全身治疗过程失败后。2 Mogamulizumab是一种针对CC趋化因子受体4（CCR 4）的单克隆抗体，CCR 4在T细胞恶性肿瘤（包括MF和SS）中表达，并且在血液室中具有68%的反应，在SS中具有37%的总反应率。3在III期MF/SS临床试验中，在接受mogamulizumab治疗的约1/4患者中观察到2级和3级药疹。3几项mogamulizumab治疗成人T细胞白血病/淋巴瘤的上市后监测病例研究报告了Stevens-Johnson综合征/中毒性表皮坏死松解症，强调了快速识别和有效治疗诱导的重要性。4
Sézary syndrome (SS) is defined by erythroderma, the presence of circulating malignant T cells in the peripheral blood, and generalized lymphadenopathy. SS is associated with a low or high disease burden depending on the presence of less or greater than 5000/μL circulating malignant cells. 1 High-risk disease requires more aggressive treatment with a combination of extracorporeal photopheresis (ECP), interferon, or bexarotene, or monotherapy with romidepsin or mogamulizumab.Mogamulizumab was approved by the US Food and Drug Administration for relapsed or refractory mycosis fungoides (MF) or SS following failure of at least one previous course of systemic therapy. 2 Mogamulizumab is a monoclonal antibody directed toward the CC chemokine receptor 4 (CCR4), which is expressed in T-cell malignancies including MF and SS, and was found to be highly effective in the blood compartment with a 68% response and in SS with a 37% overall response rate. 3 In the phase III MF/SS clinical trial, grade 2 and 3 drug rashes were seen in approximately 1 in 4 patients on mogamulizumab. 3 Several post-marketing surveillance case studies of mogamulizumab for the treatment of adult T-cell leukemia/lymphoma reported Stevens-Johnson syndrome/toxic epidermal necrolysis, underscoring the importance of swift recognition and effective treatment induction. 4