Treatment of Cutaneous T-cell Lymphoma with Cyclosporin A: Case Report and Literature Review.

A 48 year old Caucasian man with cutaneous T-cell lymphoma, stage IVB is described. Initially he presented with an ichthyosis-like dermatosis and developed lymphadenopathy, hypercalcaemia, hepatosplenomegaly and lymphomatoid papulosis over a period of 7 years. Following splenectomy he developed a leukemic phase which was refractory to polychemotherapy. Therapy with cyclosporin A initially caused deterioration of the skin infiltrations and the peripheral blood T-helper lymphocytosis. However after 3 weeks an improvement of the patient's general condition was noted including decreased skin involvement, reduction of hepatomegaly and a sustained decrease of the absolute lymphocytosis, which lasted for ten months. Lymphomatoid papulosis was not significantly affected by cyclosporin A. In conclusion, this case and several case reports from the literature suggest that cyclosporin A may be valuable in the palliative treatment of selected patients with advanced cutaneous T-cell lymphoma.