Mycosis Fungoides in Solid Organ Transplant Recipients: A Multicenter Retrospective Cohort Study.

Mycosis fungoides (MF) in solid-organ transplant recipients (SOTR) is rare, with limited data on disease characteristics.To study the characteristics of MF in SOTR with an emphasis on the immunosuppressive therapy.A retrospective cohort of patients diagnosed with MF, who were also SOTR, followed at 3 cutaneous lymphoma outpatient-clinics, between 1/2010-02/2022.Ten patients were included, (7 male; median ages at transplantation and at-diagnosis of MF were, 33 and 48 years, respectively; 40% were diagnosed before the age of 18 years). Median time from transplantation to diagnosis of MF was 8 years, (range 0.5-22). Transplanted organs and immunosuppressive treatments included: liver, (n=5; 4 treated with tacrolimus, 1 with tacrolimus and prednisone), kidney (n=3), liver and kidney (n=1), and heart (n=1), all treated with mycophenolic acid, tacrolimus, and prednisone. Nine had early-stage MF, [IA-4, IB-5; 40% with early-folliculotropic MF], treated with skin-directed-therapies, in 2 combined with acitretin, achieving partial/complete response. One patient had advanced-stage MF (IIIA) with folliculotropic erythroderma, treated with-ultraviolet A and narrowband-ultraviolet B with acitretin, achieving partial response. Immunosuppression was modified in 3. At last follow-up, (median 4 years, range 1-8), no stage-progression was observed; 5 had no evidence of disease, 5 had active disease-(IA/IB-4, III-1).MF in SOTR is usually diagnosed at an early-stage, with over representation of folliculotropic MF, and of children. Immunosuppressive therapy alterations, not conducted in most patients, should be balanced against the risk of organ compromise/rejection. Disease-course was similar to MF in immunocompetent patients, during the limited time of follow-up.S. Karger AG, Basel.

Citation

Iris Amitay-Laish, Elena Didkovsky, Batya Davidovici, Rivka Friedland, Dan Ben Amitai, Hagai Landov, Shoshana Greenberger, Ayelet Ollech, Hadas Prag Naveh, Emmilia Hodak, Aviv Barzilai. Mycosis Fungoides in Solid Organ Transplant Recipients: A Multicenter Retrospective Cohort Study. Dermatology (Basel, Switzerland). 2023 Sep 26

PMID: 37751718

search → result