Management of psoriasis-like rash associated with idelalisib monotherapy in a patient with refractory follicular lymphoma: a case report

• Main Authors: Salma Machan, Carlos Plaza, Yosmar Pérez-González, Maria Rodriguez-Pinilla, Luis Requena, Raul Cordoba
• Format: Article
• Language: English
• Published: BMC 2020-02-01
• Series: Journal of Medical Case Reports
• Subjects: Adverse drug event; Cutaneous drug reaction; Case report; Follicular lymphoma; Idelalisib; Rash
• Online Access: http://link.springer.com/article/10.1186/s13256-020-2344-9

Abstract Background Follicular lymphoma is an indolent non-Hodgkin lymphoma that is most commonly diagnosed in elderly individuals. The majority of patients with follicular lymphoma present with advanced disease. Despite the recent advances in treatment, there remains a substantial unmet need for effective treatments for patients with relapsed/refractory follicular lymphoma. The PI3Kδ inhibitor idelalisib was approved by the European Medicines Agency in 2014 as a monotherapy for the treatment of adult patients with follicular lymphoma that is refractory to two prior lines of treatment. Real-world evidence from patients with follicular lymphoma treated with idelalisib indicates its utility in these patients. Case presentation This case report describes an 82-year-old, retired, white, female patient with refractory follicular lymphoma who achieved a partial response with idelalisib treatment. Despite experiencing two incidences of a psoriasis-like rash during idelalisib treatment that required effective management with topical steroids, the patient was able to restart treatment successfully and maintain a continued partial response. Conclusions The clinical relevance of the effective management of adverse events in this case demonstrates the opportunity to enable patients to remain on therapy, thereby maintaining long-term response and improving overall outcomes.