Understanding TreatmentOptions in
Cutaneous Lymphoma
Cutaneous B-Cell Lymphomas
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Radioimmunotherapy
Radioimmunotherapy (RIT) is a targeteddelivery system tohelp kill cancerous
cells.With this treatment, amonoclonal antibody is attached to a radioactive
element.Themonoclonal antibody recognizes the cancer cells and takes the
radioactive element to the cancer cell to kill it.
RIT consists of a targeted therapy such as rituximabwith a source of radiation
attached.RIT acts as a “guidedmissile” todestroy cancer cells by attaching to
the lymphoma cell anddelivering small doses ofmedicine and radioactivity to it.
There are 2RITproducts currently approved by theFDA: yttrium-90 (
90
Y)-
ibritumomab tiuxetan (Zevalin®)
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and tositumomab (Bexxar).Both treatments
recognize the specific antigenCD20 on the surface of cancer cells inpatients
withB-cell non-Hodgkin lymphoma. In general,
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Y-ibritumomab tiuxetan and
tositumomab cause fewer side effects than traditional chemotherapy agents.
GlaxoSmithKline recently announcedplans todiscontinue themanufacture
and sale of tositumomab in 2014, so the availability of thisRITwill be limited.
For both
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Y-ibritumomab tiuxetan and tositumomab, serious complications
may include skin infections, severe allergic reactions, and temporary lowering of
blood cell counts.These drugs are usually givenwhenpatients donot respond to
rituximab.
Antibiotics
The possibility of treatingPCMZL associatedwith
B. burgdorferi
has
been considered.However, the efficacy of antibiotic treatment is poorly
documented.
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Some patients reported achieving a response following an
antibiotic regimen.There is some evidence to suggest that cephalosporinsmight
be superior tohigh-dose tetracyclines; however, this is based on very limited
experience from a fewpatients.
