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NCCN Guidelines for Patients


Mycosis Fungoides, Version 1.2016


Overview of cancer treatments HDAC inhibitors | Monoclonal antibodies

HDAC inhibitors

DNA is tightly wrapped around proteins called

histones to form chromosomes. HDAC (






etylase) removes a chemical group from

histones so that DNA can wrap more tightly. HDAC

inhibitors enter cells and block the action of HDAC.

Blocking HDACs can turn on tumor-fighting genes

that were shut off by the cancer. This can stop cell

growth or lead to cell death.

HDAC inhibitors for mycosis fungoides are briefly

described next. Some side effects are listed. Ask your

treatment team for a full list of common and rare side



Romidepsin is a liquid that will be slowly injected into

your vein for about 4 hours. It is given once a week

for the first 3 weeks of a 28-day cycle. Your doctor will

discuss with you how many cycles are needed.

Common side effects include nausea, tiredness

despite sleep (fatigue), changes in taste, and low

numbers of platelets. Sometimes numbers of other

blood cells drop. You may have an irregular heartbeat

while taking romidepsin. Romidepsin can harm

unborn babies and may decrease how well estrogen-

based birth control works.


Vorinostat is a pill that is taken once a day. It should

be taken with some food. Try to take this medicine at

the same time each day. Common side effects include

nausea, diarrhea, fatigue, fever, low numbers of

platelets, and changes in taste. Vorinostat can harm

unborn babies.

Monoclonal antibodies

Monoclonal antibodies are human-made antibodies

that attach to proteins on cancer cells. The

monoclonal antibodies used to treat lymphomas

attach to antigens. When antibodies are attached to

antigens on a cell, the cell is marked to be destroyed

by your immune system. Monoclonal antibodies are

also used to deliver chemotherapy to specific cells.

Monoclonal antibodies used for mycosis fungoides



Alemtuzumab is a monoclonal antibody that attaches

to a molecule called CD52. CD52 is found on mycosis

fungoides cells, healthy B-cells and T-cells, as well as

other cells. Alemtuzumab is not approved by the FDA

for mycosis fungoides, but often works well in treating

Sézary syndrome.

Alemtuzumab is a liquid that will be slowly injected

into your vein or under your skin. It may take

many hours to get the full dose through your vein.

Alemtuzumab is often given three times a week for 12


Common side effects include an infusion reaction

when receiving the medicine into your vein. Also,

you may feel nausea, vomit, get diarrhea, and

have trouble sleeping. Blood counts are often low

when taking this medicine. Taking alemtuzumab will

increase your chances of getting a cytomegalovirus or

other infection. Lower doses are less likely to cause


Brentuximab vedotin

Brentuximab vedotin contains a monoclonal antibody

that delivers chemotherapy to certain cells. On the

surface of large-cell transformed mycosis fungoides

cells are molecules called CD30. Brentuximab

attaches to CD30 and enters lymphoma cells. Once