The appearance of solid tumors und lymphomas during treatment with fingolimod was observed in studies and has been described in case reports.
Objective:
To report a case of primary cutaneous CD30(+) anaplastic large-cell T-cell lymphoma during treatment of multiple sclerosis (MS) with fingolimod.
Methods:
Case study.
Results:
Our patient developed a lymphoma a few weeks after initialization of therapy with fingolimod; 5 weeks after discontinuation of treatment the lesions resolved.
Conclusion:
Causality of fingolimod is indicated by the fact that the skin lesions appeared after commencement of treatment and resolved after discontinuation of therapy. This case serves as a reminder of the potential side effects of fingolimod.
KapposLO’ConnorPRadueEW. et al. Long-term effects of fingolimod in multiple sclerosis: The randomized FREEDOMS extension trial. Neurology2015; 84: 1582–1591.
2.
ConzettKBKolmIJelcicI. et al. Melanoma occurring during treatment with fingolimod for multiple sclerosis: A case report. Arch Dermatol2011; 147: 991–992.
3.
CohanSGodwinJGaedekeL. Acute lymphoblastic leukemia in a man treated with fingolimod for relapsing multiple sclerosis. J Investig Med High Impact Case Rep2015; 3: 2324709615575551.
4.
SamaraweeraAPCohenSNAkayEM. et al. Lymphomatoid papulosis: A cutaneous lymphoproliferative disorder in a patient on fingolimod for multiple sclerosis. Mult Scler2016; 22: 122–124.
5.
LorvikKBBogenBCorthayA. Fingolimod blocks immunosurveillance of myeloma and B-cell lymphoma resulting in cancer development in mice. Blood2012; 119: 2176–2177.
6.
LiuQZhaoXFrissoraF. et al. FTY720 demonstrates promising preclinical activity for chronic lymphocytic leukemia and lymphoblastic leukemia/lymphoma. Blood2008; 111: 275–284.
7.
EvangelistiCEvangelistiCTetiG. et al. Assessment of the effect of sphingosine kinase inhibitors on apoptosis, unfolded protein response and autophagy of T-cell acute lymphoblastic leukemia cells; indications for novel therapeutics. Oncotarget2014; 5: 7886–7901.
8.
GelfandJMShinDBNeimannAL. et al. The risk of lymphoma in patients with psoriasis. J Invest Dermatol2006; 126: 2194–2201.
9.
WongHKMishraAHakeT. et al. Evolving insights in the pathogenesis and therapy of cutaneous T-cell lymphoma (mycosis fungoides and Sezary syndrome). Br J Haematol2011; 155(2): 150–166.
10.
GuitartJMartinez-EscalaMEDeonizioJM. et al. CD30(+) cutaneous lymphoproliferative disorders with pseudocarcinomatous hyperplasia are associated with a T-helper-17 cytokine profile and infiltrating granulocytes. J Am Acad Dermatol2015; 72(3): 508–515.
