JL526. Rituximab and Melanoma: A Case Report
Shimika Rasha, MD, MPH, Abhishek Nair, MD, and Zdenka Segota, MD; University of Miami, Miller School of Medicine, Holy Cross Hospital, Fort Lauderdale, Florida
© 2018 Harborside™
JADPRO Live at APSHO 2017
Marriott Marquis, Houston, Texas • November 2–5, 2017
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Background: Rituximab is a monoclonal antibody directed against CD20 used in hematology for the treatment of non-Hodgkin lymphoma and chronic lymphocytic leukemia as well as in rheumatology to treat rheumatoid arthritis. Its use is also increasing in various inflammatory and autoimmune diseases. Thus, a large number of patients are being increasingly exposed to this medication. Its toxicity has been low, consisting mainly of immediate infusion reactions and infectious risks. To date, rituximab has not been associated with an increased risk of cancer. Several rituximab-associated melanoma cases, often at a metastatic stage, have been recently identified in various literature, the European pharmacovigilance database in 2012 and FDA report in 2017. This raises concern for melanoma onset secondary to rituximab in these immunosuppressed patients. Reviewing these cases also seems to raise the question of whether dermatological monitoring is essential in patients treated with rituximab, especially those who may have risk factors for melanoma.
Discussion: We report two cases of metastatic melanoma that occurred in two patients treated with rituximab for a prolonged period for non-Hodgkin lymphoma. Drawing conclusions on the harmful role of rituximab in melanoma occurrence or progression is still premature. Reporting these cases is essential to increase knowledge of the impact of rituximab on the incidence of secondary cancer and hence, to remain vigilant, especially as rituximab is currently been increasingly used and for a prolonged period. There are also ongoing studies interested in its use to treat melanoma at an early stage.
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