Abstract
Mycosis fungoides, an uncommon form of cutaneous T-cell lymphoma, arises in the skin and frequently progresses to generalized lymphadenopathy. Although the cause of cutaneous T-cell lymphoma is unknown, chronic immunosuppression may play a role. A few cases have been reported in renal transplant recipients; however, ours appears to be the 1st report of cutaneous T-cell lymphoma in a cardiac transplant recipient. In our patient, cutaneous manifestations of the disease were noted less than 1 year after transplantation. Seven years after transplantation, Sézary syndrome, a variant form of mycosis fungoides, was diagnosed by tissue biopsy and flow cytometry analysis. Photopheresis improved symptoms but was not well tolerated because of hemodynamic sequelae. Psoralen and ultraviolet A therapy also improved the patients skin condition, but a generalized lymphadenopathy developed. The maintenance immunosuppressive regimen was changed from cyclosporine (3 mg/kg/day) and azathioprine to cyclosporine (1.5 mg/kg/day) and cyclophosphamide. Although effective in the short-term, the results of this therapeutic strategy could not be fully evaluated because the patient died of acute myocardial infarction.
Original language | English (US) |
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Pages (from-to) | 203-207 |
Number of pages | 5 |
Journal | Texas Heart Institute Journal |
Volume | 28 |
Issue number | 3 |
State | Published - 2001 |
Keywords
- Cyclosporins/adverse effects
- Heart transplantation
- Herpes-viridae infections/complications
- Immunosuppression/adverse effects
- Lymphoma, T-cell, cutaneous
- Mycosis fungoides
- PUVA therapy
- Photopheresis
- Sezary syndrome
- Skin neoplasms
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine