Cutaneous T-cell Lymphoma

Treatment

Cutaneous T-cell lymphoma comes in many forms, each of which appears and progresses differently. Each form also responds differently to treatment. Mayo Clinic specialists from dermatology, hematology, oncology, radiation oncology and laboratory medicine and pathology collaborate to determine the most effective treatment plan for you. Your plan may include topical treatment, systemic treatment, light therapy, interferon, or radiation therapy or several of these therapies given in combination.

Topical treatments

Your doctor may recommend medicated creams, lotions, gels or ointments, such as:

• Corticosteroids. These are strong medications (for example, cortisone and prednisone) that reduce inflammation in your body. A lower-strength dose may be used on sensitive areas of the body, such as your face or armpits, and stronger doses may be used for skin on other parts of your body.
• Topical chemotherapy. This refers to anticancer (chemotherapy) drugs that are mixed with ointment or lotion and put on the skin, such as mechlorethamine, also called nitrogen mustard (Mustargen), and carmustine (BICNU). They help temporarily control CTCL in many people.
• Retinoids. Related to vitamin A, retinoids are used to treat many skin conditions, including cancer. Retinoids such as bexarotene (Targretin) can be helpful and may be added to other treatments.

Systemic treatments

Medications taken by mouth or given by injection or IV are called systemic treatments. Both corticosteroids and retinoids can be given systemically.

Other systemic treatments used for CTCL include chemotherapy drugs, which can be used alone or in combination. Most of these drugs are given by injection or IV but some, such as methotrexate (Rheumatrex, Trexall) are given by mouth. Typically your doctor will recommend systemic chemotherapy when the disease has spread beyond your skin or when topical therapies are not effective. Many different chemotherapy drugs are available to treat CTCL. Drugs recently approved for CTCL treatment include romidepsin (Istodax) and pralatrexate (Folotyn).

Light therapies

Light therapy, or phototherapy, uses ultraviolet light to treat cancer cells in the skin.

• Ultraviolet (UV) light. UV is the portion of the light spectrum beyond the violet end. It is often used to treat skin disorders because it slows the rapid growth of skin cells. Both ultraviolet A (UVA) and ultraviolet B (UVB) light are used to treat skin lymphoma.
• Psoralen UVA (PUVA) therapy. You may be given psoralen (SOR-uh-len) pills and then exposed to carefully measured amounts of UVA light.
• Extracorporeal photopheresis (ECP). In this treatment, your blood is drawn, circulated through a machine where it is treated with psoralen and UV light, and then returned to your body.

Immunotherapy

Immunotherapy is a form of biological therapy that harnesses your body's immune system to help fight cancer. The biological drug called interferon is a synthetic version of the immune system's natural response to viral infection. It might also be an option for you — alone or in combination with light therapy. It's typically given by injection under the skin several times a week. Interferon may:

• Improve your body's natural response to disease
• Slow the progression of the disease by interfering with the division of cancer cells

Radiation therapy

Radiation therapy involves focusing radiation on specific areas of the body to kill cancer cells. The most common type of radiation therapy used for cutaneous lymphoma is electron beam radiation.

Read more about corticosteroids, chemotherapy and radiation therapy at MayoClinic.com.