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Review
. 2022 Sep;116(3):446-452.
doi: 10.1007/s12185-022-03330-y. Epub 2022 Mar 30.

Discordant lymphomas of classic Hodgkin lymphoma and peripheral T-cell lymphoma following dupilumab treatment for atopic dermatitis

Kumi Nakazaki  1 , Mina Yoshida  1 , Yosuke Masamoto  1 , Aya Shinozaki-Ushiku  2 , Masako Ikemura  2 , Teruyoshi Hisamoto  3 , Megumi Yasunaga  1 , Shinichi Sato  3 , Mineo Kurokawa  4   5
Affiliations
Review

Discordant lymphomas of classic Hodgkin lymphoma and peripheral T-cell lymphoma following dupilumab treatment for atopic dermatitis

Kumi Nakazaki et al. Int J Hematol. 2022 Sep.

Abstract

There have recently been a few case reports of cutaneous T-cell lymphomas following treatment of atopic dermatitis with dupilumab, which works binding to the interleukin (IL)-4 receptor and inhibiting the JAK/ STAT cascade located downstream of both IL-4 and IL-13. Here, we report the first case of Hodgkin lymphoma (HL) in a patient treated with dupilumab for one year. Based on multiple biopsies, this case was diagnosed as a rare combination of discordant lymphomas of HL and peripheral T-cell lymphoma. As both lymphomas are known to overexpress IL-13, future studies should carefully evaluate the effect of anti-IL-13 therapy. A literature review showed that dermatitis persisted or worsened in all reported lymphoma cases following dupilumab and cutaneous T-cell lymphoma was diagnosed within 2 years of the start of treatment with dupilumab. In these cases, with the addition of our own, the median interval was 12 months, and 31% needed multiple biopsies for diagnosis of lymphomas. Our results demonstrate a need to be alert to potential development of lymphomas associated with the IL-13 and IL-4 pathways in patients with poorly responsive atopic dermatitis receiving dupilumab, and to consider the possibility of composite or discordant lymphomas in diagnosis and treatment of lymphomas.

Keywords: Atopic dermatitis; Discordant lymphomas; Dupilumab; Hodgkin lymphoma; Peripheral T-cell lymphoma.

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