CD30+ T-cell lymphoma in a patient with psoriasis treated with ciclosporin and infliximab

Br J Dermatol. 2003 Jul;149(1):170-3. doi: 10.1046/j.1365-2133.2003.05384.x.

Abstract

There is a known relationship between the use of immunosuppressive therapies and the development of lymphoproliferative malignancies. These lymphomas are mainly B-cell nonHodgkin's lymphomas associated with Epstein-Barr virus. Most cases concern classical immunosuppressive treatments including ciclosporin and methotrexate. A relationship between the new antitumour necrosis factor (TNF)-alpha agents and lymphoproliferative malignancies is debated. Patients with psoriasis on immunosuppressive therapies, mainly ciclosporin, are considered to have a low risk of developing lymphoid proliferation. We report a patient with erythrodermic psoriasis treated with ciclosporin and infliximab who developed a CD30+ T-cell lymphoma. This lymphoma regressed after stopping these treatments. In this case, the anti-TNF-alpha agent may have played a role in association with ciclosporin in the development of the lymphoproliferative disorder. Whereas the combination of anti-TNF-alpha therapies with methotrexate has been well studied, their combination with ciclosporin has been evaluated only in a few patients. Psoriatic patients who may require anti-TNF-alpha treatment have often been or will be treated with ciclosporin. The combination of ciclosporin and anti-TNF-alpha warrants further investigation.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antibodies, Monoclonal / adverse effects*
  • Cyclosporine / adverse effects*
  • Dermatologic Agents / adverse effects
  • Drug Therapy, Combination
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Infliximab
  • Lymphoma, Large-Cell, Anaplastic / chemically induced*
  • Lymphoma, Large-Cell, Anaplastic / pathology
  • Male
  • Middle Aged
  • Psoriasis / drug therapy*
  • Skin Neoplasms / chemically induced*
  • Skin Neoplasms / pathology

Substances

  • Antibodies, Monoclonal
  • Dermatologic Agents
  • Immunosuppressive Agents
  • Cyclosporine
  • Infliximab