A Patient’s Guide to Understanding
Cutaneous Lymphoma
42
frequent blood, electrolyte, platelet count and electrocardiogram (EKG)
monitoring for the initial weeks of therapy. Zolinza® is used alone or in
combination with other therapies.
Romidepsin (Istodax
®
)
Romidepsin or Istodax® is another histone deacetylase inhibitor (HDAC)
agent available for patients with cutaneous lymphoma who have received
at least one prior systemic therapy. Istodax® is administered by intravenous
infusion over 4 hours every week, for 3 weeks, followed by a rest week.
Similar to other HDAC agents, monitoring of blood tests including
electrolytes, magnesium and platelets is essential.
Chemotherapy
Chemotherapy administered as single agent or in combination may be used
to treat the manifestations of advanced cutaneous lymphoma. Combination
or multi-agent chemotherapy is usually reserved for advanced stages of
disease. The following single-agent chemotherapy drugs are known to be
“gentler,” so they do not cause much hair loss or vomiting. With most of
these agents, physicians will monitor blood counts and kidney and liver
function.
Methotrexate (Matrex®)
is an anti-metabolite agent used for a host of
immune-based diseases. It interferes with folic acid metabolism in cancer
cells. In cutaneous lymphoma, this is administered in oral form by pill
weekly.
Pralatrexate (Folotyn®)
is used in the treatment of transformed
mycosis fungoides and other aggressive non-Hodgkin’s lymphomas
such as peripheral T-cell lymphoma. It is a folate metabolic inhibitor
which targets the same pathway as methotrexate. Patients receiving
pralatrexate therapy take a daily dose of folic acid and receive Vitamin
B 12 injections every 8 to 12 weeks. It is delivered intravenously every 3
weeks, followed by a rest week.
Alemtuzumab (Campath®)
is a monoclonal antibody directed against
the CD52 antigen (surface marker) found on both B-lymphocytes
and T-lymphocytes. It is typically administered in low-dose form by
subcutaneous injection 3 days per week for an 8-12 week course. Patients
receiving Campath® are prescribed oral antibiotics and antiviral
