Sp22 | Complete Response to Reduced-dose Brentuximab Vedotin in a Geriatric Patient With Mycosis Fungoides: a Case Report
Year: 2025
Type: article
Abstract: Background: Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma (CTCL), characterized by indolent progression in early stages. Treatment regimens often include topical therapies, radiation, and systemic agents. Brentuximab vedotin (BV), an anti-CD30 monoclonal antibody conjugated with a microtubule-disrupting agent, has shown efficacy in CTCL. However, its role in elderly patients, particularly with dose reductions due to comorbidities, remains to be further explored. Case Presentation: We present the case of an 88-year-old male diagnosed with MF in January 2019 and referred to our center in November 2024 with numerous diffuse ulcerated and hemorrhagic cutaneous lesions in tumor stage (IIB), which were progressing under bexarotene treatment. Previous treatments included narrowband UVB, repeated courses of radiotherapy/brachytherapy, and bath-PUVA, with increasing resistance over time, prompting the need for further systemic intervention. A new skin biopsy documented CD30 expression in approximately 60% of the infiltrate and a high proliferative index (Mib1/Ki67: 70%). The patient was started on BV at a reduced dose (1.2 mg/kg) after comprehensive evaluation of his clinical condition and age-related factors. The patient exhibited an excellent response to treatment, with a complete response (CR) observed after three cycles of BV. Systemic toxicity was minimal, with manageable hematologic side effects including neutropenia, which gradually improved. Aside from transient joint pain and fatigue, no significant adverse events were reported, and the patient experienced a general improvement in his condition. Two additional cycles of BV were administered as consolidation therapy, with a prolonged interval (every 5 weeks) to minimize side effects in consideration of the patient's age and sustained response. After the fifth cycle, the patient remained in stable condition, with complete remission of the cutaneous manifestations of MF. Conclusion: This case highlights the efficacy and tolerability of reduced-dose BV in achieving complete remission in an elderly patient with stage IIB mycosis fungoides. The treatment regimen, tailored to the patient’s advanced age and comorbidities, suggests that BV can be safely and effectively used in this population.
Authors: I. Monella, A. Breda, A. Bramati, B. Boido, A.G. Croci, G. Aquilino, M.B. Ventre, N. Frungillo, S. Girlanda, L. Leuzzi, I. Casetti, V. Rossi, F. De Gregorio, S. Alberti-Violetti, F. Onida
Language: English
Subfield: Dermatology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7093121487
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