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NCCN Guidelines for Patients


Mycosis Fungoides, Version 1.2016



Genetic counseling | Treatment

4.2 Stages IB and IIA treatment


Treatment guide

Stages IB a d IIA tr t


Start with first-line treatments:


Try another course of

first-line treatments if:

• Treatment worked at

first but the cancer

came back as stage I or

IIA, or

• Only 1 or 2 treatments

were tried and didn’t


Switch to second-line treatments if:

• Multiple courses of first-line treatment didn’t work, or

• The cancer is worse and is a higher cancer stage


Chart 4.2.2 Second-line treatments

Options for widespread treatment

• Clinical trial

• Systemic treatment

◦◦ Oral retinoids

◦◦ Interferons

◦◦ HDAC-inhibitors (ie, belinostat,vorinostat, romidepsin)

◦◦ Extracorporeal photopheresis

◦◦ Methotrexate

• Combination treatment ± skin treatment

Chart 4.2.1

First-line treatments

Options for

local skin treatments

• Generalized skin treatment ± local skin treatment:

Generalized skin treatments

◦◦ Topical steroids

◦◦ Topical chemotherapy (ie, mechlorethamine)

◦◦ Phototherapy

◦◦ Total skin electron beam therapy

Local skin treatments used after generalized

◦◦ Local radiation therapy

◦◦ Topical retinoids (ie, bexarotene, tazarotene)

◦◦ Topical imiquimod