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Blood, 18 June 2009, Vol. 113, No. 25, pp. 6338-6341. Prepublished online as a Blood First Edition Paper on April 23, 2009; DOI 10.1182/blood-2009-03-210989. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2009-03-210989v1 113/25/6338    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Google Scholar Articles by Marneros, A. G. Articles by Zain, J. M. PubMed PubMed Citation Articles by Marneros, A. G. Articles by Zain, J. M. Related Collections Lymphoid Neoplasia Brief Reports Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Brief report Pralatrexate-induced tumor cell apoptosis in the epidermis of a patient with HTLV-1 adult T-cell lymphoma/leukemia causing skin erosions Alexander G. Marneros1, Marc E. Grossman1, David N. Silvers1, Sameera Husain1, Gerard J. Nuovo2, Barbara MacGregor-Cortelli3, Ellen Neylon3, Molly Patterson3, Owen A. O'Connor3,4, and Jasmine M. Zain3,4 1 Department of Dermatology, Columbia Presbyterian Medical Center, New York, NY; 2 Comprehensive Cancer Center, Ohio State University Medical Center, Columbus; 3 Department of Medicine, Columbia Presbyterian Medical Center, New York, NY; and 4 Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY Pralatrexate is a novel antifolate, which shows increased antitumor activity in human tumor xenograft studies in mice compared with methotrexate. We investigated the effects of pralatrexate in a patient with adult T-cell lymphoma/leukemia with significant skin involvement. Atypical lymphocytes in epidermal Pautrier microabscesses were positive for HTLV-1. After the patient presented with leukemic conversion and with worsening of an erythematous generalized papular rash, he received one dose of pralatrexate. Within one week, his skin developed innumerable small erosions limited to the areas of the papular rash, sparing unaffected skin. Here we present in vivo evidence that pralatrexate-induced erosions in skin affected by adult T-cell lymphoma/leukemia are a manifestation of apoptosis of tumor cells infiltrating the epidermis and are not the result of cytotoxicity by pralatrexate on keratinocytes. This distinction is critical and may profoundly influence the clinical decision to continue pralatrexate treatment. Pralatrexate-induced skin erosions may indicate response to treatment. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Cutaneous tumor lysis syndrome in a patient with HTLV-1 adult T-cell lymphoma/leukemia Jean-David Bouaziz, Nadège Cordel, Geoffroy Hickman, Claire Fieschi, Nicolas Ortonne, and Martine Bagot Blood 2009 114: 4320-4321. [Full Text] [PDF] This article has been cited by other articles: J.-D. Bouaziz, N. Cordel, G. Hickman, C. Fieschi, N. Ortonne, and M. Bagot Cutaneous tumor lysis syndrome in a patient with HTLV-1 adult T-cell lymphoma/leukemia Blood, November 5, 2009; 114(19): 4320 - 4321. [Full Text] [PDF]

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