MİKOZİS FUNGOİDES TEDAVİSİNDE RETİNOİDLER

Yıl 2018, Cilt: 3 Sayı: 1, 10 - 16, 06.04.2018

Emin Özlü , Ragıp Ertaş

Öz

Mikozis fungoides (MF) en sık görülen kutane T hücreli lenfoma (KTHL) formudur. Hastalık yavaş seyirliden agresif hızlı seyirli formlara kadar değişken klinik seyri vardır. MF tedavisinde birçok alternatif mevcuttur ve deriyi hedefleyen tedavilerden kemoterapiye kadar değişen farklı yöntemler tedavide kullanılır. Retinoidler hücre proliferasyonu, diferansiyasyonu ve apoptozisi düzenleyen ve immün yanıtı etkileyen A vitamini türevleridir. Retinoidler MF tedavisinde uzun yıllardır kullanılmaktadır ancak etki mekanizması belirsizliğini korumaktadır. Retinoidler uygulama kolaylığı ve nispeten düşük toksisite profili nedeniyle MF’in tüm evrelerinde tedavi seçeneklerinin önemli bir bileşenidir. Beksaroten KTHL tedavisinde Gıda ve İlaç İdaresi (FDA) tarafından onaylanan ilk retinoiddir. MF tedavisinde retinoidlerin diğer ajanlarla kombinasyonu iyi tolere edilir ve nükseden, dirençli hastalarda daha yüksek tedavi cevabı ile ilişkilidir. Bu derlemede, MF hastalarında retinoidlerin kullanımı ile ilgili litetarür bilgileri gözden geçirlmiştir.

Anahtar Kelimeler

Mikozis fungoides, retinoidler, tedavi

Kaynakça

• 1- Huen AO, Kim EJ. The role of systemic retinoids in the treatment of cutaneous T-cell lymphoma. Dermatol Clin 2015; 33: 715-29.
• 2- Zhang C, Duvic M. Treatment of cutaneous T-cell lymphoma with retinoids. Dermatol Ther 2006; 19: 264-71.
• 3- Pileri A, Delfino C, Grandi V, et al. Role of bexarotene in the treatment of cutaneous T-cell lymphoma: the clinical and immunological sides. Immunotherapy 2013; 5: 427-33.
• 4- Bradford PT, Devesa SS, Anderson WF, et al. Cutaneous lymphoma incidence patterns in the United States: a population-based study of 3884 cases. Blood 2009; 113: 5064-73.
• 5- Stadler R, Kremer A. Therapeutic advances in cutaneous T-cell lymphoma (CTCL): from retinoids to rexinoids. Semin Oncol 2006; 33: S7-10.
• 6- Sokołowska-Wojdyło M, Lugowska-Umer H, Maciejewska-Radomska A. Oral retinoids and rexinoids in cutaneous T-cell lymphomas. Postepy Dermatol Alergol 2013; 30: 19-29.
• 7- Zhang C, Hazarika P, Ni X, et al. Induction of apoptosis by bexarotene in cutaneous T-cell lymphoma cells: relevance to mechanism of therapeutic action. Clin Cancer Res 2002; 8: 1234-40.
• 8- Yen WC, Prudente RY, Corpuz MR, et al. A selective retinoid X receptor agonist bexarotene (LGD1069, targretin) inhibits angiogenesis and metastasis in solid tumours. Br J Cancer 2006; 94: 654-60.
• 9- Gordy C, Dzhagalov I, He YW. Regulation of CD8 (+) T cell functions by RARgamma. Semin Immunol 2009; 21: 2-7.
• 10- Rook AH, Kubin M, Fox FE, et al. The potential therapeutic role of interleukin-12 in cutaneous T-cell lymphoma. Ann N Y Acad Sci 1996; 795: 310-8.
• 11- Kessler JF, Meyskens FL Jr, Levine N, et al. Treatment of cutaneous T-cell lymphoma (mycosis fungoides) with 13-cis-retinoic acid. Lancet 1983; 1: 1345-7.
• 12- Leverkus M, Rose C, Bröcker EB, et al. Follicular cutaneous T-cell lymphoma: beneficial effect of isotretinoin for persisting cysts and comedones. Br J Dermatol 2005; 152: 193-4.
• 13- Woo YR, Lee HM, Lee JS, et al. Long-term follow-up of refractory mycosis fungoides which achieved remission with the addision of isotretinoin to methotrexate and psoralen plus ultraviolat a therapy. Ann Dermatol 2013; 25: 259-60.
• 14- Claudy AL, Rouchouse B, Boucheron S, et al. Treatment of cutaneous lymphoma with etretinate. Br J Dermatol 1983; 109: 49-56.
• 15- Cheeley J, Sahn RE, DeLong LK, et al. Acitretin for the treatment of cutaneous T-cell lymphoma. J Am Acad Dermatol 2013; 68: 247-54.
• 16- Baykal C, Sun GP, Yazganoğlu KD. Superficial cutaneous hemorrhagic lesions in three mycosis fungoides patients using acitretin. Dermatol Ther 2017;30.
• 17- Duvic M, Martin AG, Kim Y, et al; Worldwide Bexarotene Study Group. Phase 2 and 3 clinical trial of oral bexarotene (Targretin capsules) for the treatment of refractory or persistent early-stage cutaneous T-cell lymphoma. Arch Dermatol 2001; 137: 581-93.
• 18- Duvic M, Hymes K, Heald P, et al; Bexarotene Worldwide Study Group. Bexarotene is effective and safe for treatment of refractory advanced-stage cutaneous T-cell lymphoma: multinational phase II-III trial results. J Clin Oncol 2001; 19: 2456-71.
• 19- Abbott RA, Whittaker SJ, Morris SL, et al. Bexarotene therapy for mycosis fungoides and Sézary syndrome. Br J Dermatol 2009; 160: 1299-307.
• 20- Talpur R, Ward S, Apisarnthanarax N, et al. Optimizing bexarotene therapy for cutaneous T-cell lymphoma. J Am Acad Dermatol 2002; 47: 672–684.
• 21- Vakeva L, Ranki A, Hahtola S. Ten-year experience of bexarotene therapy for cutaneous T-cell lymphoma in Finland. Acta Derm Venereol 2012; 92: 258-63.
• 22- Breneman D, Duvic M, Kuzel T, et al. Phase 1 and 2 trial of bexarotene gel for skin-directed treatment of patients with cutaneous T-cell lymphoma. Arch Dermatol 2002; 138: 325-32.
• 23- Yazganoglu KD, Topkarci Z, Buyukbabani N, et al. Childhood mycosis fungoides: a report of 20 cases from Turkey. J Eur Acad Dermatol Venereol 2013; 27: 295-300.
• 24- Kapser C, Herzinger T, Ruzicka T, et al. Treatment of cutaneous T-cell lymphoma with oral alitretinoin. J Eur Acad Dermatol Venereol 2015; 29: 783-8.
• 25- Apisarnthanarax N, Talpur R, Ward S, et al. Tazarotene 0.1% gel for refractory mycosis fungoides lesions: an open-label pilot study. J Am Acad Dermatol 2004; 50: 600-7.
• 26- Thomsen K, Hammar H, Molin L, et al. Retinoids plus PUVA (RePUVA) and PUVA in mycosis fungoides, plaque stage. A report from the Scandinavian Mycosis Fungoides Group. Acta Derm Venereol 1989; 69: 536-8.
• 27- Stadler R, Otte HG, Luger T, et al. Prospective randomized multicenter clinical trial on the use of interferon -2a plus acitretin versus interferon -2a plus PUVA in patients with cutaneous T-cell lymphoma stages I and II. Blood 1998; 92: 3578-81.
• 28- Whittaker S, Ortiz P, Dummer R, et al. Efficacy and safety of bexarotene combined with psoralen-ultraviolet A (PUVA) compared with PUVA treatment alone in stage IB-IIA mycosis fungoides: final results from the EORTC Cutaneous Lymphoma Task Force phase III randomized clinical trial (NCT00056056). Br J Dermatol 2012; 167: 678-87.
• 29- Panchal MR, Scarisbrick JJ. The utility of bexarotene in mycosis fungoides and Sézary syndrome. Onco Targets Ther 2015; 8: 367-73.
• 30- Straus DJ, Duvic M, Kuzel T, et al. Results of a phase II trial of oral bexarotene (Targretin) combined with interferon alfa-2b (Intron-A) for patients with cutaneous T-cell lymphoma. Cancer 2007; 109: 1799-803.
• 31- Illidge T, Chan C, Counsell N, et al. Phase II study of gemcitabine and bexarotene (GEMBEX) in the treatment of cutaneous T-cell lymphoma. Br J Cancer 2013; 109: 2566-73.
• 32- Talpur R, Thompson A, Gangar P, et al. Pralatrexate alone or in combination with bexarotene: long-term tolerability in relapsed/refractory mycosis fungoides. Clin Lymphoma Myeloma Leuk 2014; 14: 297-304.