T-cell Lymphoma

Treatment

Mayo Clinic specialists from Dermatology, Hematology, Oncology, Radiation Oncology, and Laboratory Medicine and Pathology collaborate to determine the most effective treatment plan for each patient. A patient's plan may include topical treatment, systemic treatment, light therapy, interferons, or radiation therapy or several of these therapies given in combination.

Topical treatments involve medicated creams, lotions, gels, and ointments. Mayo dermatologists may prescribe one of two topical medications, cortisone or nitrogen mustard ointment. Cortisone reduces inflammation. Lower-strength cortisone preparations may be used on sensitive areas of the body such as the face or armpits, and stronger doses may be used to treat affected skin elsewhere. A topical preparation that contains nitrogen mustard ointment and lotion is referred to as topical chemotherapy. The ointment or lotion containing the nitrogen mustard is applied daily over affected areas. It has proven effective in temporarily controlling CTCL in many people.

Systemic treatments refer to medications taken by mouth rather than applied to the skin. They include corticosteroids, retinoids, methotrexate, and systemic chemotherapy. Corticosteroids (prednisone, for example) are powerful anti-inflammatories. Retinoids are derived from vitamin A and are used only under the careful supervision of a Mayo Clinic dermatologist. Methotrexate is an oral anti-cancer drug, a systemic chemotherapy that travels through the patient's body, killing cancer cells.

Light therapies used to treat T-cell lymphoma include ultraviolet light, psoralen UVA (PUVA) therapy, and extracorporeal photopheresis (ECP).

• Ultraviolet light (the portion of the light spectrum beyond the violet end) is often used to treat skin disorders because it slows the rapid growth of skin cells. It is safe and effective under a doctor's care.
• During PUVA treatment, people with CTCL are given psoralen pills and then exposed to carefully measured amounts of UVA light.
• In extracorporeal photopheresis, blood is drawn from a vein and then circulated through a machine in which it is sensitized with psoralen and exposed to ultraviolet light. The blood is then returned to the body. ECP is effective because it selectively destroys cancerous cells.

Interferons are biological response modifiers that can improve the body's natural response to disease. When used to treat CTCL, interferons slow the progression of the disease by interfering with the division of cancer cells. Interferon is usually given by injection under the skin several times a week.

Radiation therapy involves focusing X-ray radiation on specific areas of the body to kill cancer cells.