Discordant lymphomas of classic Hodgkin lymphoma and peripheral T-cell lymphoma following dupilumab treatment for atopic dermatitis.

Abstract

There have recently been a few case reports of cutaneous T-cell lymphomas following treatment of atopic dermatitis with dupilumab, which works binding to the interleukin (IL)-4 receptor and inhibiting the JAK/ STAT cascade located downstream of both IL-4 and IL-13. Here, we report the first case of Hodgkin lymphoma (HL) in a patient treated with dupilumab for one year. Based on multiple biopsies, this case was diagnosed as a rare combination of discordant lymphomas of HL and peripheral T-cell lymphoma. As both lymphomas are known to overexpress IL-13, future studies should carefully evaluate the effect of anti-IL-13 therapy. A literature review showed that dermatitis persisted or worsened in all reported lymphoma cases following dupilumab and cutaneous T-cell lymphoma was diagnosed within 2 years of the start of treatment with dupilumab. In these cases, with the addition of our own, the median interval was 12 months, and 31% needed multiple biopsies for diagnosis of lymphomas. Our results demonstrate a need to be alert to potential development of lymphomas associated with the IL-13 and IL-4 pathways in patients with poorly responsive atopic dermatitis receiving dupilumab, and to consider the possibility of composite or discordant lymphomas in diagnosis and treatment of lymphomas.

• Authors: Kumi Nakazaki, Mina Yoshida, Yosuke Masamoto, Aya Shinozaki-Ushiku, Masako Ikemura, Teruyoshi Hisamoto, Megumi Yasunaga, Shinichi Sato, Mineo Kurokawa
• Journal: International journal of hematology (Int J Hematol) Vol. 116 Issue 3 Pg. 446-452 (Sep 2022) ISSN: 1865-3774 [Electronic] Japan
• PMID: 35355217 (Publication Type: Case Reports, Journal Article, Review)
• Copyright: © 2022. Japanese Society of Hematology.

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Interleukin-4
• dupilumab

Topics

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Dermatitis, Atopic (diagnosis, drug therapy, pathology)
• Hodgkin Disease (drug therapy)
• Humans
• Interleukin-4
• Lymphoma, T-Cell, Peripheral