文章：

皮肤T细胞淋巴瘤中与低剂量阿仑单抗最佳应答相关的长期结局和临床表型

Long-term outcomes and clinical phenotypes associated with best response to low dose alemtuzumab in cutaneous T-cell lymphoma

原文发布日期：2025-04-17

DOI: 10.1038/s41408-025-01237-5

类型: Article

开放获取: 是

英文摘要：

Cutaneous T-cell lymphomas (CTCL) have in common malignant T-lymphocyte infiltration in the skin. Low dose alemtuzumab (LDA) appears to be an effective treatment for leukemic disease, but in the absence of clinical trials, there is need for improved characterization of patients with CTCL most likely to benefit. A retrospective cohort study of 38 patients with CTCL treated with LDA with at least 5 years’ follow-up data was conducted. As a surrogate for a central memory T-cell (TCM) clinical phenotype, we evaluated whether the absence of a history of papules, plaques, and tumors (PPT) predicts better global and skin response. Twenty-five (65.8%) patients responded to LDA (95% CI: 49–80%). Patients with a TCM phenotype were more than eight times as likely to achieve a CR [OR: 8.2, 95% CI: 1.2–57.6]. CR rate in the skin was 81.8% in TCM phenotype patients compared to 37.0% in patients with a history of PPT (resident memory T-cell phenotype, TRM) [OR: 7.7, 95% CI: 1.4–42.7]. Three patients experienced any infection requiring systemic intervention. LDA monotherapy can safely produce exceptional response rates in those presenting with diffuse erythema but without a history of PPT.
 

摘要翻译： 

皮肤T细胞淋巴瘤（CTCL）的共同特征为皮肤中存在恶性T淋巴细胞浸润。低剂量阿仑单抗（LDA）似乎是白血病性病变的有效疗法，但在缺乏临床试验的情况下，需进一步明确最可能受益的CTCL患者特征。本研究对38例接受LDA治疗且具有至少5年随访数据的CTCL患者进行了回顾性队列分析。为替代中央记忆T细胞（TCM）临床表型，我们评估了无丘疹、斑块和肿瘤（PPT）病史是否能预测更好的整体及皮肤应答。25例（65.8%）患者对LDA产生应答（95%置信区间：49–80%）。具有TCM表型的患者获得完全缓解的可能性高出八倍以上[比值比：8.2，95%置信区间：1.2–57.6]。TCM表型患者的皮肤完全缓解率达81.8%，而有PPT病史（定居记忆T细胞表型，TRM）的患者仅为37.0%[比值比：7.7，95%置信区间：1.4–42.7]。3例患者出现需要全身干预的感染。对于表现为弥漫性红斑但无PPT病史的患者，LDA单药治疗可安全实现卓越的应答率。

原文链接：

Long-term outcomes and clinical phenotypes associated with best response to low dose alemtuzumab in cutaneous T-cell lymphoma