Drug-induced cutaneous vasculitis in patients with non-Hodgkin lymphoma treated with the novel proteasome inhibitor bortezomib: A possible surrogate marker of response? Journal Article

  

Authors:	Gerecitano, J.; Goy, A.; Wright, J.; Macgregor-Cortelli, B.; Neylon, E.; Gonen, M.; Esseltine, D.; Boral, A.; Schenkein, D.; Busam, K.; Teruya-Feldstein, J.; Sachs, D.; O'Connor, O. A.
Article Title:	Drug-induced cutaneous vasculitis in patients with non-Hodgkin lymphoma treated with the novel proteasome inhibitor bortezomib: A possible surrogate marker of response?
Abstract:	Bortezomib is the first proteasome inhibitor to be approved for use in haematological malignancies. Although a rash has been described as a common adverse event associated with the drug, it has not been well characterised. Based on three phase II studies of bortezomib in patients with non-Hodgkin lymphoma (140 assessable patients), we identified 26 patients who developed a unique erythematous maculopapular rash during treatment, six of whom underwent cutaneous biopsy. Punch biopsy in six patients revealed a perivascular lymphocytic infiltrate without evidence of lymphoma, consistent with a non-necrotising cutaneous vasculitis. The combined overall response rate was 41%. The response in the 26 patients who developed a rash was 73%, compared with 33% in patients who did not. The odds ratio for response given the development of a rash was 4.6 (95% CI, 1.7-12.4, P = 0.001). This is the first report to characterise a vasculitic rash associated with bortezomib, and to show a relationship between development of the rash and response to treatment. Unlike classic hypersensitivity type reactions, this vasculitic rash may not necessarily prompt cessation of drug. In fact, the development of an isolated cutaneous vasculitis may portend a better clinical response to bortezomib in some patients. © 2006 The Authors.
Keywords:	adult; clinical article; controlled study; human tissue; treatment outcome; aged; middle aged; drug efficacy; bortezomib; proteasome inhibitor; drug eruption; boronic acids; protease inhibitors; pyrazines; skin biopsy; logistic models; punch biopsy; drug hypersensitivity; pruritus; rash; skin; maculopapular rash; nonhodgkin lymphoma; lymphoma, non-hodgkin; lymphoma; erythema; papule; lymphocytic infiltration; antihistaminic agent; cutaneous vasculitis; vasculitic rash; skin diseases, vascular
Journal Title:	British Journal of Haematology
Volume:	134
Issue:	4
ISSN:	0007-1048
Publisher:	John Wiley & Sons
Date Published:	2006-08-01
Start Page:	391
End Page:	398
Language:	English
DOI:	10.1111/j.1365-2141.2006.06201.x
PUBMED:	16882131
PROVIDER:	scopus
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-33746056833&partnerID=40&md5=b70eff5deba62038c22b75e3209ac8fa
Notes:	--- - "Cited By (since 1996): 28" - "Export Date: 4 June 2012" - "CODEN: BJHEA" - "Source: Scopus"

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