Aprepitant for refractory cutaneous T-cell lymphoma-associated pruritus: 4 cases and a review of the literature

BMC Cancer. 2017 Mar 16;17(1):200. doi: 10.1186/s12885-017-3194-8.

Abstract

Background: Aprepitant is an FDA-approved medication for chemotherapy-induced nausea and vomiting. It blocks substance P binding to neurokinin-1; substance P has been implicated in itch pathways both as a local and global mediator.

Case presentations: We report a series of four patients, diagnosed with cutaneous T-cell lymphoma, who experienced full body pruritus recalcitrant to standard therapies. All patients experienced rapid symptom improvement (within days) following aprepitant treatment.

Conclusion: Aprepitant has been shown in small studies to be efficacious for treating chronic and malignancy-associated pruritus. Prior studies have shown no change in clinical efficacy of chemotherapeutics with concurrent aprepitant administration. These cases further demonstrate that aprepitant can be considered as a therapeutic option in malignancy-associated pruritus and further support the need for larger clinical trials.

Keywords: Aprepitant; Case report; Cutaneous T-cell lymphoma; Emend; Itch; Pruritus.

Publication types

  • Case Reports
  • Meta-Analysis

MeSH terms

  • Adult
  • Aged
  • Aprepitant
  • Female
  • Humans
  • Lymphoma, T-Cell, Cutaneous / complications
  • Lymphoma, T-Cell, Cutaneous / drug therapy*
  • Lymphoma, T-Cell, Cutaneous / genetics
  • Lymphoma, T-Cell, Cutaneous / pathology
  • Male
  • Middle Aged
  • Morpholines / administration & dosage*
  • Neurokinin-1 Receptor Antagonists / administration & dosage
  • Protein Binding / drug effects
  • Pruritus / drug therapy*
  • Pruritus / genetics
  • Pruritus / pathology
  • Substance P / antagonists & inhibitors
  • Substance P / genetics

Substances

  • Morpholines
  • Neurokinin-1 Receptor Antagonists
  • Aprepitant
  • Substance P