Treating Cutaneous Lymphoma
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increased appetite, stomach irritation, mood elevation, sleep disturbance,
acne, and delayed wound healing.
Interferons (IFN)
Interferon is a naturally-occurring protein that carries anti-viral, anti-
tumor, and immunological properties, and can be manufactured in large
amounts for use as a drug. In the management of advanced-stage CTCL,
physicians seek immune stimulatory effects. Interferon alfa 2b (Intron A®)
and Interferon gamma 1b (Actimmune®) represent two different categories
of synthetic interferons used in treating this disease. Interferon is patient-
administered by subcutaneous injection 3 days per week. Laboratory tests
to monitor complete blood count and liver function are required. Most
often interferon is used in combination with other therapeutic modalities
such as photopheresis.
Bexarotene (Targretin
®
) Capsules
Bexarotene or Targretin® is a Vitamin A derived agent that belongs to a
larger class of medicines called retinoids. Retinoid X receptors (RXRs)
steer abnormal T-cells toward cell death. Oral Targretin® is a systemic
agent approved for all stages of cutaneous T-cell lymphoma. Laboratory
monitoring (blood tests) of both lipids and thyroid hormone are required
during the course of this therapy.
Denileukin Diftitox (Ontak
®
)
Denileukin Diftitox or Ontak® is an approved drug for the treatment
of recalcitrant cutaneous lymphoma. It is a fusion toxin formed by the
combination of diphtheria and interleukin-2. Ontak® is selectively cytotoxic
to malignant T-cells. Nurses administer Ontak® by intravenous infusion
over the course of a 1-1/2 hr. time period. Typically patients receive Ontak®
5 consecutive days (a cycle) every 3 weeks for 6 cycles. Maintenance therapy
may be recommended if clinical remission is achieved. At the time of the
publication of this guide, the company that makes Ontak® has stopped
manufacturing the medication and there is no information as to when
production may resume.
Vorinostat (Zolinza
®
)
Vorinostat or Zolinza® is a histone deacetylase inhibitor (HDAC)
oral agent for patients with progressive or persistent manifestations
of cutaneous lymphoma. HDAC inhibition allows a cell’s DNA to be
transcribed so that cancer cells may die off. This medication requires
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