Spontaneous Regression Of Tumor-stage Cutaneous T-cell Lymphoma In A Multiple Sclerosis Patient After Discontinuing Fingolimod
Froehlich, A., Schmidt, S., Landsberg, J., Bieber, T., & Wenzel, J. (2018). Spontaneous regression of tumor-stage cutaneous T-cell lymphoma in a multiple sclerosis patient after discontinuing fingolimod. Multiple sclerosis (Houndmills, Basingstoke, England), 24(13), 1785–1787. https://doi.org/10.1177/1352458518774444
View Original Source →Case Details
Disease Location
Skin
Personal Characteristics
44-year-old female, 17-year history of highly active relapsing-remitting multiple sclerosis (ms). Stage 1a cutaneous t-cell lymphoma
Clinical Characteristics
Ulcerated tumor on her right scapula, 4 months after her ms treatment had been switched from natalizumab to fingolimod. Biopsy showed epidermotropic dermal infiltrate dominated by atypical cd4+t-cells, consistent with mycosis fungoides, patch-stage (ctcl), stage 2b. Treatment with fingolimod was discontinued. After remission treatment with methotrexate 15 mg/week was initiated.
Remission Characteristics
4 weeks following discontinuation of fingolimod the tumor showed a spontaneous regression.
Treatment & Mechanisms
Proposed Remission Mechanisms
Ingolimod might have blocked the migration of tumor-controlling t-lymphocytes from the lymph node to the peripheral tumor cells, whereas the proliferation of the neoplastic cells in the skin remained unaffected. Therefore, discontinuation of the medication restored immune function.
Clinical Treatment
Biopsy fingolimod methotrexate
Non-Clinical Treatment
None reported