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Acitretin potentially effective treatment for cutaneous T-cell lymphoma

Acitretin therapy for patients with cutaneous T-cell lymphoma was well tolerated and potentially effective, according to study results.

Researchers in Atlanta conducted a retrospective chart review of 32 patients with cutaneous T-cell lymphoma (CTCL; mean age, 56 years; 56% men) treated with acitretin at a tertiary care center. Twenty-nine patients had mycosis fungoides, two had Sézary syndrome and one had unspecified CTCL. At acitretin initiation, 3% of patients were stage IA CTCL, 69%, stage IB/IIA; 16%, stage IIB; 6%, stage III; and 6%, stage IV. Six patients received acitretin, with the other 26 assigned acitretin and another CTCL therapy, most commonly nitrogen mustard among the 19 responders.

Overall response rate was 59% and occurred at a median duration of 28.1 months. Eight patients experienced stable disease, while five developed progressive CTCL. Five patients discontinued therapy because of adverse, generally mild events that included xerosis/skin peeling (22%), chelitis (13%), dyslipidemia (13%), alopecia (9%) and depression (9%).

“The only FDA-approved systemic retinoid for the treatment of cutaneous T-cell lymphoma is oral bexarotene, which frequently induces adverse effects,” the researchers concluded. “Acitretin should be considered for treatment of patients with CTCL, either as an adjuvant to standard therapy, or in scenarios where other agents [eg, topical mechlorethamine, phototherapy, bexarotene] are not practical, not available, or not affordable.

“Whether response to acitretin is a surrogate marker of response to bexarotene has yet to be determined. Additional reports and larger studies … are needed.”

Disclosure: Researcher Sareeta R. Parker, MD, is an investigator on an Eisai-sponsored clinical trial using two different dosing schedules of bexarotene for CTCL.