, Volume 70, Issue 3, pp 273–286 | Cite as

Current and Emerging Treatment Strategies for Cutaneous T-cell Lymphoma

Review Article


Cutaneous T-cell lymphomas (CTCLs) are a rare group of mature T-cell lymphomas presenting primarily in the skin. The most common subtypes of CTCL are mycosis fungoides and its leukaemic variant Sézary’s syndrome. Patients with early-stage disease frequently have an indolent clinical course; however, those with advanced stages have a shortened survival. For the treating physician, the question of how to choose a particular therapy in the management of CTCL is important. These diseases span the disciplines of dermatology, medical oncology and radiation oncology. Other than an allo-geneic stem cell transplant, there are no curative therapies for this disease. Hence, many treatment modalities need to be offered to the patient over the course of their life. An accepted treatment approach has been to delay traditional chemotherapy, which can cause excessive toxicity without durable benefit. More conservative treatment strategies in the initial management of CTCL have led to the development of newer biological and targeted therapies. These therapies include biological immune enhancers such as interferon a and extracorporeal photopheresis that exert their effect by stimulating an immune response to the tumour cells. Retinoids such as bexarotene have been shown to be effective and well tolerated with predictable adverse effects. The fusion toxin denileukin diftitox targets the interleukin-2 receptor expressed on malignant T cells. Histone deacetylase inhibitors such as vorinostat and romidepsin (depsipeptide) may reverse the epigenetic states associated with cancer. Forodesine is a novel inhibitor of purine nucleoside phosphorylase and leads to apoptosis of malignant T cells. Pralatrexate is a novel targeted antifolate that targets the reduced folate carrier in cancer cells. Lastly, systemic chemotherapy including transplantation is used when rapid disease control is needed or if all other biological therapies have failed. As response rates to most of the biological agents used to treat CTCL are 25–30%, it is also reasonable to consider clinical trials with novel agents if one or two front-line therapies have failed, especially before considering chemotherapy. CTCL is largely an incurable disease with significant morbidity and more active agents are needed.



No sources of funding were used to assist in the preparation of this article. Dr Foss has acted as a consultant for Gloucester Pharmaceuticals and Eisai Pharmaceuticals. Dr Lansigan has no conflicts of interest that are relevant to the content of this review.


  1. 1.
    Willemze R, Jaffe ES, Burg G, et al. WHO-EORTC classification for cutaneous lymphomas. Blood 2005 May 15; 105(10): 3768–85PubMedCrossRefGoogle Scholar
  2. 2.
    Criscione VD, Weinstock MA. Incidence of cutaneous T-cell lymphoma in the United States, 1973–2002. Arch Dermatol 2007 Jul; 143(7): 854–9PubMedCrossRefGoogle Scholar
  3. 3.
    Olsen E, Vonderheid E, Pimpinelli N, et al. Revisions to the staging and classification of mycosis fungoides and Sezary syndrome: a proposal of the International Society for Cutaneous Lymphomas (ISCL) and the cutaneous lymphoma task force of the European Organization of Research and Treatment of Cancer (EORTC). Blood 2007 Sep 15; 110(6): 1713–22PubMedCrossRefGoogle Scholar
  4. 4.
    Bunn PAJ, Lamberg SI. Report of the Committee on Staging and Classification of Cutaneous T-Cell Lymphomas. Cancer Treat Rep 1979; 63(4): 725–8PubMedGoogle Scholar
  5. 5.
    Sausville EA, Eddy JL, Makuch RW, et al. Histopathologic staging at initial diagnosis of mycosis fungoides and the Sezary syndrome: definition of three distinctive prognostic groups. Ann Intern Med 1988 Sep 1; 109(5): 372–82PubMedGoogle Scholar
  6. 6.
    Demierre MF, Kim YH, Zackheim HS. Prognosis, clinical outcomes and quality of life issues in cutaneous T-cell lymphoma. Hematol Oncol Clin North Am 2003 Dec; 17(6): 1485–507PubMedCrossRefGoogle Scholar
  7. 7.
    Vonderheid EC, Bernengo MG, Burg G, et al. Update on erythrodermic cutaneous T-cell lymphoma: report of the International Society for Cutaneous Lymphomas. J Am Acad Dermatol 2002 Jan; 46(1): 95–106PubMedCrossRefGoogle Scholar
  8. 8.
    Heald P. Probing the immune dysregulation in cutaneous T cell lymphomas. J Invest Dermatol 2005 Dec; 125(6): xvi–iiPubMedCrossRefGoogle Scholar
  9. 9.
    National Comprehensive Cancer Network (NCCN). Clinical practice guidelines in oncology—v.2. 2009. Fort Washington (PA): NCCN, 2009Google Scholar
  10. 10.
    Trautinger F, Knobler R, Willemze R, et al. EORTC consensus recommendations for the treatment of mycosis fungoides/ Sezary syndrome. Eur J Cancer 2006 May; 42(8): 1014–30PubMedCrossRefGoogle Scholar
  11. 11.
    Zackheim HS, Kashani-Sabet M, Amin S. Topical corti-costeroids for mycosis fungoides: experience in 79 patients. Arch Dermatol 1998 Aug; 134(8): 949–54PubMedCrossRefGoogle Scholar
  12. 12.
    Hoppe RT, Abel EA, Deneau DG, et al. Mycosis fungoides: management with topical nitrogen mustard. J Clin Oncol 1987 Nov;5(11): 1796–803PubMedGoogle Scholar
  13. 13.
    Vonderheid EC, Tan ET, Kantor AF, et al. Long-term efficacy, curative potential, and carcinogenicity of topical mechlorethamine chemotherapy in cutaneous T cell lymphoma. J Am Acad Dermatol 1989 Mar; 20(3): 416–28PubMedCrossRefGoogle Scholar
  14. 14.
    Mahrle G, Thiele B. Retinoids in cutaneous T cell lymphomas. Dermatologica 1987; 175 Suppl. 1: 145–50CrossRefGoogle Scholar
  15. 15.
    Breneman D, Duvic M, Kuzel T, et al. Phase 1 and 2 trial of bexarotene gel for skin-directed treatment of patients with cutaneous T-cell lymphoma. Arch Dermatol 2002 Mar; 138(3): 325–32PubMedCrossRefGoogle Scholar
  16. 16.
    Takemori N, Hirai K. Significance of PUVA therapy for adult T-cell leukemia/lymphoma: PUVA therapy can induce apoptosis in leukemic cells. Hum Cell 1995 Sep; 8(3): 121–6PubMedGoogle Scholar
  17. 17.
    Abel EA, Sendagorta E, Hoppe RT, et al. PUVA treatment of erythrodermic and plaque-type mycosis fungoides: ten-year follow-up study. Arch Dermatol 1987 Jul; 123(7): 897–901PubMedCrossRefGoogle Scholar
  18. 18.
    Honigsmann H, Brenner W, Rauschmeier W, et al. Photochemotherapy for cutaneous T cell lymphoma: a follow-up study. J Am Acad Dermatol 1984 Feb; 10 (2 Pt 1): 238–45PubMedCrossRefGoogle Scholar
  19. 19.
    Ramsay DL, Lish KM, Yalowitz CB, et al. Ultraviolet-B phototherapy for early-stage cutaneous T-cell lymphoma. Arch Dermatol 1992 Jul; 128(7): 931–3PubMedCrossRefGoogle Scholar
  20. 20.
    Clark C, Dawe RS, Evans AT, et al. Narrowband TL-01 phototherapy for patch-stage mycosis fungoides. Arch Dermatol 2000 Jun; 136(6): 748–52PubMedCrossRefGoogle Scholar
  21. 21.
    Gathers RC, Scherschun L, Malick F, et al. Narrowband UVB phototherapy for early-stage mycosis fungoides. J Am Acad Dermatol 2002 Aug; 47(2): 191–7PubMedCrossRefGoogle Scholar
  22. 22.
    Hofer A, Cerroni L, Kerl H, et al. Narrowband (311-nm) UV-B therapy for small plaque parapsoriasis and early-stage mycosis fungoides. Arch Dermatol 1999 Nov; 135(11): 1377–80PubMedCrossRefGoogle Scholar
  23. 23.
    Duvic M, Lemak NA, Redman JR, et al. Combined modality therapy for cutaneous T-cell lymphoma. J Am Acad Dermatol 1996 Jun; 34(6): 1022–9PubMedCrossRefGoogle Scholar
  24. 24.
    Jones G, McLean J, Rosenthal D, et al. Combined treatment with oral etretinate and electron beam therapy in patients with cutaneous T-cell lymphoma (mycosis fungoides and Sezary syndrome). J Am Acad Dermatol 1992 Jun; 26(6): 960–7PubMedCrossRefGoogle Scholar
  25. 25.
    Micaily B, Campbell O, Moser C, et al. Total skin electron beam and total nodal irradiation of cutaneous T-cell lymphoma. Int J Radiat Oncol Biol Phys 1991 Apr; 20(4): 809–13PubMedCrossRefGoogle Scholar
  26. 26.
    Price NM. Topical mechlorethamin: cutaneous changes in patients with mycosis fungoides after its administration. Arch Dermatol 1977 Oct; 113(10): 1387–9PubMedCrossRefGoogle Scholar
  27. 27.
    Wilson LD, Licata AL, Braverman IM, et al. Systemic chemotherapy and extracorporeal photochemotherapy for T3 and T4 cutaneous T-cell lymphoma patients who have achieved a complete response to total skin electron beam therapy. Int J Radiat Oncol Biol Phys 1995 Jul 15; 32(4): 987–95PubMedCrossRefGoogle Scholar
  28. 28.
    Hoppe RT. Total skin electron beam therapy in the management of mycosis fungoides. Front Radiat Ther Oncol 1991; 25: 80–9; discussion 132-3PubMedGoogle Scholar
  29. 29.
    Jones GW, Rosenthal D, Wilson LD. Total skin electron radiation for patients with erythrodermic cutaneous T-cell lymphoma (mycosis fungoides and the Sezary syndrome). Cancer 1999 May 1; 85(9): 1985–95PubMedGoogle Scholar
  30. 30.
    Quiros PA, Jones GW, Kacinski BM, et al. Total skin electron beam therapy followed by adjuvant psoralen/ ultra violet-A light in the management of patients with T1 and T2 cutaneous T-cell lymphoma (mycosis fungoides). Int J Radiat Oncol Biol Phys 1997 Jul 15; 38(5): 1027–35PubMedCrossRefGoogle Scholar
  31. 31.
    Wilson LD, Quiros PA, Kolenik SA, et al. Additional courses of total skin electron beam therapy in the treatment of patients with recurrent cutaneous T-cell lymphoma. J Am Acad Dermatol 1996 Jul; 35(1): 69–73PubMedCrossRefGoogle Scholar
  32. 32.
    Knobler RM. Photopheresis. Extracorporeal irradiation of 8-MOP containing blood: a new therapeutic modality. Blut 1987 Apr; 54(4): 247–50PubMedCrossRefGoogle Scholar
  33. 33.
    Gasparro FP, Chan G, Edelson RL. Phototherapy and photopharmacology. Yale J Biol Med 1985 Nov–Dec; 58(6): 519–34PubMedGoogle Scholar
  34. 34.
    Edelson RL. Cutaneous T cell lymphoma: the helping hand of dendritic cells. Ann N Y Acad Sci 2001 Sep; 941: 1–11PubMedCrossRefGoogle Scholar
  35. 35.
    Berger CL, Hanlon D, Kanada D, et al. The growth of cutaneous T-cell lymphoma is stimulated by immature dendritic cells. Blood 2002 Apr 15; 99(8): 2929–39PubMedGoogle Scholar
  36. 36.
    Edelson R, Berger C, Gasparro F, et al. Treatment of cutaneous T-cell lymphoma by extracorporeal photo-chemotherapy: preliminary results. N Engl J Med 1987 Feb 5; 316(6): 297–303PubMedCrossRefGoogle Scholar
  37. 37.
    Zic JA, Miller JL, Stricklin GP, et al. The North American experience with photopheresis. Ther Apher 1999 Feb; 3(1): 50–62PubMedCrossRefGoogle Scholar
  38. 38.
    Zic J, Arzubiaga C, Salhany KE, et al. Extracorporeal photopheresis for the treatment of cutaneous T-cell lymphoma. J Am Acad Dermatol 1992 Nov; 27 (5 Pt 1): 729–36PubMedCrossRefGoogle Scholar
  39. 39.
    Arulogun S, Prince HM, Gambell P, et al. Extracorporeal photopheresis for the treatment of Sezary syndrome using a novel treatment protocol. J Am Acad Dermatol 2008 Oct; 59(4): 589–95PubMedCrossRefGoogle Scholar
  40. 40.
    Scarisbrick JJ, Taylor P, Holtick U, et al. UK consensus statement on the use of extracorporeal photopheresis for treatment of cutaneous T-cell lymphoma and chronic graftversus-host disease. Br J Dermatol 2008 Apr; 158(4): 659–78PubMedCrossRefGoogle Scholar
  41. 41.
    Miller JD, Kirkland EB, Domingo DS, et al. Review of extracorporeal photopheresis in early-stage (IA, IB, and IIA) cutaneous T-cell lymphoma. Photodermatol Photoimmunol Photomed 2007 Oct; 23(5): 163–71PubMedCrossRefGoogle Scholar
  42. 42.
    Dippel E, Schrag H, Goerdt S, et al. Extracorporeal photopheresis and interferon-alpha in advanced cutaneous T-cell lymphoma. Lancet 1997 Jul 5; 350(9070): 32–3PubMedCrossRefGoogle Scholar
  43. 43.
    Tsirigotis P, Pappa V, Papageorgiou S, et al. Extracorporeal photopheresis in combination with bexarotene in the treatment of mycosis fungoides and Sezary syndrome. Br J Dermatol 2007 Jun; 156(6): 1379–81PubMedCrossRefGoogle Scholar
  44. 44.
    Wilson LD, Jones GW, Kim D, et al. Experience with total skin electron beam therapy in combination with extracorporeal photopheresis in the management of patients with erythrodermic (T4) mycosis fungoides. J Am Acad Dermatol 2000 Jul; 43 (1 Pt 1): 54–60PubMedCrossRefGoogle Scholar
  45. 45.
    Stadler R. Optimal combination with PUVA: rationale and clinical trial update. Oncology (Williston Park) 2007 Feb; 21 (2 Suppl. 1): 29–32Google Scholar
  46. 46.
    Bunn Jr PA, Foon KA, Ihde DC, et al. Recombinant leukocyte A interferon: an active agent in advanced cutaneous T-cell lymphomas. Ann Intern Med 1984 Oct; 101(4): 484–7PubMedGoogle Scholar
  47. 47.
    Olsen EA, Rosen ST, Vollmer RT, et al. Interferon alfa-2a in the treatment of cutaneous T cell lymphoma. J Am Acad Dermatol 1989 Mar; 20(3): 395–407PubMedCrossRefGoogle Scholar
  48. 48.
    Olsen EA. Interferon in the treatment of cutaneous T-cell lymphoma. Dermatol Ther 2003; 16(4): 311–21PubMedCrossRefGoogle Scholar
  49. 49.
    McGinnis KS, Ubriani R, Newton S, et al. The addition of interferon gamma to oral bexarotene therapy with photopheresis for Sezary syndrome. Arch Dermatol 2005 Sep; 141(9): 1176–8PubMedCrossRefGoogle Scholar
  50. 50.
    Dummer R, Dobbeling U, Geertsen R, et al. Interferon resistance of cutaneous T-cell lymphoma-derived clonal T-helper 2 cells allows selective viral replication. Blood 2001 Jan 15; 97(2): 523–7PubMedCrossRefGoogle Scholar
  51. 51.
    Urosevic M. Drug evaluation: TG-1042, an adenovirusmediated IFNgamma gene delivery for the intratumoral therapy of primary cutaneous lymphomas. Curr Opin Investig Drugs 2007 Jun; 8(6): 493–8PubMedGoogle Scholar
  52. 52.
    Dummer R, Hassel JC, Fellenberg F, et al. Adenovirus-mediated intralesional interferon-gamma gene transfer induces tumor regressions in cutaneous lymphomas. Blood 2004 Sep 15; 104(6): 1631–8PubMedCrossRefGoogle Scholar
  53. 53.
    Transgene. Study to evaluate the safety and efficacy of adeno-IFN gamma in cutaneous B-cell lymphoma [Clinical Trials.gov identifier NCT00394693]. US National Institutes of Health, ClinicalTrials.gov [online]. Available from URL: http://www.clinicaltrials.gov [Accessed 2010 Jan 11]
  54. 54.
    Duvic M, Sherman ML, Wood GS, et al. A phase II open-label study of recombinant human interleukin-12 in patients with stage IA, IB, or IIA mycosis fungoides. J Am Acad Dermatol 2006 Nov; 55(5): 807–13PubMedCrossRefGoogle Scholar
  55. 55.
    Duvic M, Hymes K, Heald P, et al. Bexarotene is effective and safe for treatment of refractory advanced-stage cutaneous T-cell lymphoma: multinational phase II–III trial results. J Clin Oncol 2001 May 1; 19(9): 2456–71PubMedGoogle Scholar
  56. 56.
    Olsen E, Duvic M, Frankel A, et al. Pivotal phase III trial of two dose levels of denileukin diftitox for the treatment of cutaneous T-cell lymphoma. J Clin Oncol 2001 Jan 15; 19(2): 376–88PubMedGoogle Scholar
  57. 57.
    Negro-Vilar A, Dziewanowska A, Groves ES, et al. Efficacy and safety of denileukin diftitox (Dd) in a phase III, double-blind, placebo-controlled study of CD25+ patients with cutaneous T-cell lymphoma (CTCL) [abstract no. 8026]. J Clin Oncol ASCO Ann Meet Proc 2007; 25 (Jun 20 Suppl. Pt 1): 18SGoogle Scholar
  58. 58.
    Negro-Vilar A, Prince HM, Duvic M, et al. Efficacy and safety of denileukin diftitox (Dd) in cutaneous T-cell lymphoma (CTCL) patients: integrated analysis of three large phase III trials [abstract no. 8551]. J Clin Oncol 2008 May 20; 26 (Suppl.)Google Scholar
  59. 59.
    Ontak. Prescribing information [online]. Available from URL: http://www.ontak.com/hcp-prescribing-information.asp [Accessed 2010 Jan 11]
  60. 60.
    Ruddle JB, Harper CA, Honemann D, et al. A denileukin diftitox (Ontak) associated retinopathy? Br J Ophthalmol 2006 Aug; 90(8): 1070–1PubMedCrossRefGoogle Scholar
  61. 61.
    Foss F, Demierre MF, DiVenuti G. A phase-1 trial of bexarotene and denileukin diftitox in patients with relapsed or refractory cutaneous T-cell lymphoma. Blood 2005 Jul 15; 106(2): 454–7PubMedCrossRefGoogle Scholar
  62. 62.
    Lundin J, Hagberg H, Repp R, et al. Phase 2 study of alemtuzumab (anti-CD52 monoclonal antibody) in patients with advanced mycosis fungoides/Sezary syndrome. Blood 2003 Jun 1; 101(11): 4267–72PubMedCrossRefGoogle Scholar
  63. 63.
    Kennedy GA, Seymour JF, Wolf M, et al. Treatment of patients with advanced mycosis fungoides and Sezary syndrome with alemtuzumab. Eur J Haematol 2003 Oct; 71(4): 250–6PubMedCrossRefGoogle Scholar
  64. 64.
    Kim YH, Duvic M, Obitz E, et al. Clinical efficacy of zanolimumab (HuMax-CD4): two phase 2 studies in refractory cutaneous T-cell lymphoma. Blood 2007 Jun 1; 109(11): 4655–62PubMedCrossRefGoogle Scholar
  65. 65.
    Bolden JE, Peart MJ, Johnstone RW. Anticancer activities of histone deacetylase inhibitors. Nat Rev Drug Discov 2006 Sep; 5(9): 769–84PubMedCrossRefGoogle Scholar
  66. 66.
    Johnstone RW. Histone-deacetylase inhibitors: novel drugs for the treatment of cancer. Nat Rev Drug Discov 2002 Apr; 1(4): 287–99PubMedCrossRefGoogle Scholar
  67. 67.
    Marks PA, Richon VM, Miller T, et al. Histone deacetylase inhibitors. Adv Cancer Res 2004; 91: 137–68PubMedCrossRefGoogle Scholar
  68. 68.
    Olsen EA, Kim YH, Kuzel TM, et al. Phase IIb multicenter trial of vorinostat in patients with persistent, progressive, or treatment refractory cutaneous T-cell lymphoma. J Clin Oncol 2007 Jul 20; 25(21): 3109–15PubMedCrossRefGoogle Scholar
  69. 69.
    Piekarz RL, Robey R, Sandor V, et al. Inhibitor of histone deacetylation, depsipeptide (FR901228), in the treatment of peripheral and cutaneous T-cell lymphoma: a case report. Blood 2001 Nov 1; 98(9): 2865–8PubMedCrossRefGoogle Scholar
  70. 70.
    Bates S, Piekarz R, Wright J, et al. Final clinical results of a phase 2 NCI multicenter study of romidepsin in recurrent cutaneous T-cell lymphoma (molecular analyses included). ASH Annual Meeting Abstracts 2008 Nov 16; 112(11): 1568Google Scholar
  71. 71.
    Duvic M, Becker JC, Dalle S, et al. Phase II trial of oral panobinostat (lbh589) in patients with refractory cutaneous T-cell lymphoma (CTCL). ASH Annual Meeting Abstracts 2008 Nov 16; 112(11): 1005Google Scholar
  72. 72.
    O’Connor OA, Pro B, Pinter-Brown L, et al. PROPEL: a multi-center phase 2 open-label study of pralatrexate (PDX) with vitamin B12 and folic acid supplementation in patients with replapsed or refractory peripheral T-cell lymphoma. ASH Annual Meeting Abstracts 2008; 112: 261Google Scholar
  73. 73.
    Horwitz SM, Duvic M, Kim Y, et al. Pralatrexate (PDX) IS active in cutaneous T-cell lymphoma: preliminary results of a multi-center dose-finding trial. ASH Annual Meeting Abstracts 2008 Nov 16; 112(11): 1569Google Scholar
  74. 74.
    Duvic M, Forero-Torres A, Foss F, et al. Long-term treatment of CTCL with the oral PNP inhibitor, forodesine [abstract no. 8552]. J Clin Oncol 2009; 27 Suppl.: 15sCrossRefGoogle Scholar
  75. 75.
    BioCryst Pharmaceuticals. Forodesine in the treatment of cutaneous T-cell lymphoma [ClinicalTrials.gov identifier NCT00501735]. US National Institutes of Health, ClinicalTrials.gov [online]. Available from URL: http://www.clinicaltrials.gov [Accessed 2010 Jan 11]
  76. 76.
    Zinzani PL, Baliva G, Magagnoli M, et al. Gemcitabine treatment in pretreated cutaneous T-cell lymphoma: experience in 44 patients. J Clin Oncol 2000 Jul; 18(13): 2603–6PubMedGoogle Scholar
  77. 77.
    Duvic M, Talpur R, Wen S, et al. Phase II evaluation of gemcitabine monotherapy for cutaneous T-cell lymphoma. Clin Lymphoma Myeloma 2006 Jul; 7(1): 51–8PubMedCrossRefGoogle Scholar
  78. 78.
    Von Hoff DD, Dahlberg S, Hartstock RJ, et al. Activity of fludarabine monophosphate in patients with advanced mycosis fungoides: a Southwest Oncology Group study. J Natl Cancer Inst 1990 Aug 15; 82(16): 1353–5CrossRefGoogle Scholar
  79. 79.
    Kuzel TM, Hurria A, Samuelson E, et al. Phase II trial of 2-chlorodeoxyadenosine for the treatment of cutaneous T-cell lymphoma. Blood 1996 Feb 1; 87(3): 906–11PubMedGoogle Scholar
  80. 80.
    Saven A, Carrera CJ, Carson DA, et al. 2-Chlorodeoxy-adenosine: an active agent in the treatment of cutaneous T-cell lymphoma. Blood 1992 Aug 1; 80(3): 587–92PubMedGoogle Scholar
  81. 81.
    O’Brien S, Kurzrock R, Duvic M, et al. 2-Chlorodeoxyadenosine therapy in patients with T-cell lymphoproliferative disorders. Blood 1994 Aug 1; 84(3): 733–8PubMedGoogle Scholar
  82. 82.
    Kurzrock R, Pilat S, Duvic M. Pentostatin therapy of T-cell lymphomas with cutaneous manifestations. J Clin Oncol 1999 Oct; 17(10): 3117–21PubMedGoogle Scholar
  83. 83.
    Wollina U, Dummer R, Brockmeyer NH, et al. Multicenter study of pegylated liposomal doxorubicin in patients with cutaneous T-cell lymphoma. Cancer 2003 Sep 1; 98(5): 993–1001PubMedCrossRefGoogle Scholar
  84. 84.
    Zinzani PL, Musuraca G, Tani M, et al. Phase II trial of proteasome inhibitor bortezomib in patients with relapsed or refractory cutaneous T-cell lymphoma. J Clin Oncol 2007 Sep 20; 25(27): 4293–7PubMedCrossRefGoogle Scholar
  85. 85.
    Akpek G, Koh HK, Bogen S, et al. Chemotherapy with etoposide, vincristine, doxorubicin, bolus cyclophosphamide, and oral prednisone in patients with refractory cutaneous T-cell lymphoma. Cancer 1999 Oct 1; 86(7): 1368–76PubMedCrossRefGoogle Scholar
  86. 86.
    Duvic M, Talpur R, Ni X, et al. Phase 2 trial of oral vorinostat (suberoylanilide hydroxamic acid, SAHA) for refractory cutaneous T-cell lymphoma (CTCL). Blood 2007 Jan 1; 109(1): 31–9PubMedCrossRefGoogle Scholar
  87. 87.
    Marchi E, Alinari L, Tani M, et al. Gemcitabine as frontline treatment for cutaneous T-cell lymphoma: phase II study of 32 patients. Cancer 2005 Dec 1; 104(11): 2437–41PubMedCrossRefGoogle Scholar
  88. 88.
    Foss FM, Ihde DC, Breneman DL, et al. Phase II study of pentostatin and intermittent high-dose recombinant interferon alfa-2a in advanced mycosis fungoides/Sezary syndrome. J Clin Oncol 1992 Dec; 10(12): 1907–13PubMedGoogle Scholar
  89. 89.
    Olavarria E, Child F, Woolford A, et al. T-cell depletion and autologous stem cell transplantation in the management of tumour stage mycosis fungoides with peripheral blood involvement. Br J Haematol 2001 Sep; 114(3): 624–31PubMedCrossRefGoogle Scholar
  90. 90.
    Herbert KE, Spencer A, Grigg A, et al. Graft-versus-lymphoma effect in refractory cutaneous T-cell lymphoma after reducedintensity HLA-matched sibling allogeneic stem cell transplantation. Bone Marrow Transplant 2004 Sep; 34(6): 521–5PubMedCrossRefGoogle Scholar

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© Adis Data Information BV 2010

Authors and Affiliations

  1. 1.Hematology/OncologyDartmouth-Hitchcock Medical CenterLebanonUSA
  2. 2.Hematological Malignancies, Medical OncologyYale Cancer CenterNew HavensUSA

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