Successful outcomes of brentuximab vedotin therapy in recurrent/refractory cutaneous T-cell lymphomas: two case reports

Gorenkova L.G., Kravchenko S.K., Belousova I.E.

1 National Research Center for Hematology, Moscow, Russian Federation (Russia)
2 Medical Military Academy Saint-Petersburg Medical Social Institute

Primary cutaneous T-cell lymphomas encompass a heterogeneous group of T-cell lymphoproliferative disorders developing primarily in the skin and characterized by a number of specific diagnostic, clinical, and therapeutic features. Mycosis fungoides accounts for more than half of all cutaneous lymphoma cases, while CD30+ lymphoproliferative diseases of the skin (primary cutaneous anaplastic large-cell lymphoma and lymphomatoid papulosis) constitute one-fourth of them and the remaining cases are rare tumour types, including primary cutaneous peripheral T-cell lymphoma, unspecified/not otherwise specified.
Activation antigen СD30 is a cell membrane glycoprotein of the tumour necrosis factor family. More than 75% of primary cutaneous CD30-positive lymphoma cells express CD30; it may be detected in other diseases as well, but to a lesser extent.
Most patients with cutaneous CD30+ lymphoproliferative diseases have indolent disease and a favourable prognosis; resistant disease is observed in approximately 30% of sufferers, and fatal outcomes occur in 8% of cases.
Systemic immunomodulatory therapy or chemotherapy is often used in advanced disease. Monoclonal antibodies were recently introduced into clinical practice for the treatment of cutaneous lymphomas. One of these agents is brentuximab vedotin, a CD30-monoclonal antibody conjugated to monomethyl auristatin E.
We present two case reports: one of frequently recurring lymphomatoid papulosis and the other of refractory primary cutaneous peripheral T-cell lymphoma, unspecified/not otherwise specified. Targeted therapy with brentuximab vedotin, either alone or in combination with chemotherapy, resulted in a sustained, long-lasting remission in both cases.