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Published on: July 11, 2013
Acitretin for the treatment of cutaneous T-cell lymphoma
Justin Cheeley1, Rachel E Sahn, Laura K DeLong
1Department of Dermatology, Emory University, Atlanta, Georgia 30322, USA.
Background:
Bexarotene is the only Food and Drug Administration-approved retinoid for the treatment of cutaneous T-cell lymphoma (CTCL) and is associated with a relatively high frequency of adverse effects. Acitretin has anecdotally been reported to be effective for CTCL.
Objective:
We sought to determine the effectiveness and tolerability of acitretin as primary or adjuvant therapy for CTCL.
Methods:
We conducted a retrospective chart review of patients with CTCL treated with acitretin at a single tertiary care center.
Results:
A total of 32 patients with CTCL were included: 29 had mycosis fungoides, 2 had Sézary syndrome, and 1 had CTCL not otherwise specified. Median patient age was 55 years; 56% were male; 47% were white, 47% black, and 6% other. In all, 3% of patients were stage IA, 69% stage IB/IIA, 16% stage IIB, 6% stage III, and 6% stage IV. Six patients received acitretin alone; 26 received acitretin in addition to another CTCL therapy. The overall response rate was 59%. In all, 25% of patients had stable disease and 16% had progressive disease. Median duration of response was 28 months. Adverse effects were generally mild with 5 patients discontinuing therapy because of these.
Limitations:
In this small retrospective chart review, many patients were on other CTCL therapies while on acitretin; therefore precise assessment of response to acitretin alone was difficult.
Conclusions:
Acitretin is well tolerated and potentially effective for early-stage CTCL. Response to acitretin, either as adjuvant therapy monotherapy, is comparable with the response to oral agents currently approved for this disease.
