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Journal of the American Academy of Dermatology
Volume 58, n° 3
pages 480-484 (mars 2008)
Doi : 10.1016/j.jaad.2007.12.012
Case Reports

CD4+ CD56+ hematodermic/plasmacytoid dendritic cell tumor with response to pralatrexate
 

Justin J. Leitenberger, BS a, Cindy N. Berthelot, MD a, , Kristel D. Polder, MD a, Barbara Pro, MD b, Peter McLaughlin, MD b, Dan Jones, MD, PhD c, Madeleine Duvic, MD a
a Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas 
b Department of Lymphoma, The University of Texas MD Anderson Cancer Center, Houston, Texas 
c Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas 

Reprint requests: Cindy N. Berthelot, MD, Department of Dermatology, The University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Box 434, Houston, Texas 77030-4009.
Abstract

The CD4+ CD56+ hematodermic/plasmacytoid dendritic cell tumor is a rare, highly aggressive, systemic neoplasm for which effective therapies have not yet been established. These tumors express CD4, CD56, CD123, and T-cell leukemia/lymphoma (TCL)-1 and are clinically characterized by cutaneous involvement with spread to bone marrow and blood, and poor prognosis with current chemotherapy regimens. We describe a Caucasian woman who presented with plasmacytoid dendritic cell tumor, but an absence of systemic symptoms. Clinically, multiple cutaneous lesions were brown to violaceous firm nodules on the face, arms, and trunk. The patient underwent two courses of cyclophosphamide, Adriamycin, vincristine, and prednisone chemotherapy but relapsed quickly. The investigational agent, pralatrexate (30 mg/m2) was given weekly with vitamin B12 and folic acid and resulted in remarkable clinical response with regression of skin tumors. Our observation highlights pralatrexate as a promising therapeutic option for hematodermic/plasmacytoid dendritic cell lymphoma/leukemias.

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Abbreviations used : CHOP, pDC, NK, TCL



 Supported in part by Sherry L. Anderson Cutaneous T-cell Lymphoma Research Fund, National Institutes of Health Grant K24-CA86815, and MD Anderson Core Grant CA16672.
 Conflicts of interest: None declared.



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