Cutaneous T cell lymphoma: update of treatment.
The state-of-the art therapy of cutaneous T cell lymphoma (CTCL) is reviewed. Commonly used treatments for early-stage (patch/plaque) mycosis fungoides (MF) include topical corticosteroids, mechlorethamine, carmustine, ultraviolet light B and PUVA. Total skin electron beam (TSEB) therapy is indicated for widespread infiltrated plaque and tumor stage disease. Low-dose methotrexate is often useful for resistant patch/plaque MF and erythrodermic CTCL. Interferon alpha (IFN-alpha) is indicated for methotrexate failures and recurrent tumors following TSEB therapy. Photopheresis may be helpful for early-stage erythrodermic CTCL but is very costly. Retinoids may be of value for early and moderately advanced CTCL particularly in combination with other agents such as IFN-alpha and PUVA. Systemic disease usually requires combination chemotherapy such as that used for non-Hodgkin's lymphoma; however, responses are usually short lived.
Zackheim
H S
HS
Department of Dermatology, University of California, San Francisco, CA, USA. hszackheim@orca.ucsf.edu
D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000627:therapeutic use; D001610:Beta Particles; D002330:Carmustine / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D016410:Lymphoma, T-Cell, Cutaneous / Q000188:drug therapy* / Q000532:radiotherapy*; D008466:Mechlorethamine / Q000008:administration & dosage / Q000627:therapeutic use; D008727:Methotrexate / Q000627:therapeutic use; D011701:PUVA Therapy; D012176:Retinoids / Q000627:therapeutic use; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D016896:Treatment Outcome; D014466:Ultraviolet Rays
D000305:Adrenal Cortex Hormones; D018906:Antineoplastic Agents, Alkylating; D016898:Interferon-alpha; D012176:Retinoids; D008466:Mechlorethamine; D002330:Carmustine; D008727:Methotrexate