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Case Reports
. 2025;65(1):55-61.
doi: 10.3960/jslrt.24048.

ALK-negative anaplastic large cell lymphoma with TP53 mutation developing during the administration of baricitinib for atopic dermatitis - A case report

Hidetsugu Kawai  1 , Shino Iwata  1 , Sawako Shiraiwa  1 , Masashi Miyaoka  2 , Daisuke Ogiya  1 , Masako Toyosaki  1 , Shinichiro Machida  1 , Rikio Suzuki  1 , Makoto Onizuka  1 , Yoshiaki Ogawa  1 , Naoya Nakamura  2 , Hiroshi Kawada  1
Affiliations
Case Reports

ALK-negative anaplastic large cell lymphoma with TP53 mutation developing during the administration of baricitinib for atopic dermatitis - A case report

Hidetsugu Kawai et al. J Clin Exp Hematop. 2025.

Abstract

Severe atopic dermatitis (AD) is known to be associated with a risk of lymphoma. We herein report a case of ALK-negative anaplastic large cell lymphoma (ALK-ALCL) complicated by severe AD during treatment with baricitinib, which is an oral, selective, and reversible Janus Kinase (JAK) 1 and 2 inhibitor used in the treatment of AD. Next-generation sequencing (NGS) demonstrated the TP53 p.G266E mutation, suggesting that this was the trigger of the disease and the cause of its refractory course. The JAK/signal transducer and activator of transcription (STAT) pathway is often activated in tumor cells of ALCLs, suggesting that it is a therapeutic target. The causal connection between baricitinib and lymphomagenesis remains unknown; however, this patient developed ALK-ALCL with TP53 mutations during baricitinib treatment.

Keywords: ALK-negative anaplastic large cell lymphoma; TP53 mutation; atopic dermatitis; baricitinib.

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Conflict of interest statement

CONFLICT OF INTEREST

The authors declare no conflicts of interest in association with the present study.

Figures

Fig. 1
Fig. 1
The picture of skin (A), (B), (C) At the diagnosis of ALCL, the pictures of back, legs, and arms were showed.
Fig. 2
Fig. 2
The histological appearance (A) The infiltration of lymphoma cells in the small intestinal mass (HE 400×). Immunohistochemical analysis of the expression of (B) CD3, (C) CD4, (D) CD20, (E) CD30, (F) MUM-1, (G) MIB-1, and (H) ALK (400× magnification). Immunohistochemistry was positive for CD4, CD30, MUM-1 and MIB-1 (90%), and negative for CD3 and CD20.
Fig. 3
Fig. 3
Imaging findings and the clinical course (A) Computed tomography (CT) was performed for the diagnosis. Red arrows show enlargement of both axillary lymph nodes, and red circles show enlargement of the mesenteric lymph nodes and a small intestinal mass. (B) The clinical course from the diagnosis to death. Arrows represent different types of chemotherapy. BV-CHP, brentuximab vedotin, cyclophosphamide, adriamycin, and prednisolone; CHASE, cyclophosphamide, cytarabine, etoposide, and dexamethasone; GCD, gemcitabine, carboplatin, and dexamethasone; MCEC, ranimustine, carboplatin, etoposide, and cyclophosphamide; Auto PBSCT, autologous peripheral blood stem cell transplantation. The blue bars indicate the use of prednisolone (PSL). The changes in LDH, CRP, and sIL-2R levels are shown by a line plot.
See this image and copyright information in PMC

References

    1. Bieber T, Katoh N, Simpson EL, et al. Safety of baricitinib for the treatment of atopic dermatitis over a median of 1.6 years and up to 3.9 years of treatment: an updated integrated analysis of eight clinical trials. J Dermatolog Treat. 2023; 34: 2161812. - PubMed
    1. Swerdlow SH, Campo E, Pileri SA, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016; 127: 2375-2390. - PMC - PubMed
    1. Morris SW, Kirstein MN, Valentine MB, et al. Fusion of a kinase gene, ALK, to a nucleolar protein gene, NPM, in non-Hodgkin’s lymphoma. Science. 1994; 263: 1281-1284. - PubMed
    1. Zhang XR, Chien PN, Nam SY, Heo CY. Anaplastic Large Cell Lymphoma: Molecular Pathogenesis and Treatment. Cancers (Basel). 2022; 14: 1650. - PMC - PubMed
    1. Lobello C, Tichy B, Bystry V, et al. STAT3 and TP53 mutations associate with poor prognosis in anaplastic large cell lymphoma. Leukemia. 2021; 35: 1500-1505. - PMC - PubMed

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