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NCCN Guidelines for Patients


Mycosis Fungoides, Version 1.2016



Genetic counseling | Treatment

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 4.3.4 Second-line treatments

Treatment options

• Multi-agent chemotherapy

• Consider allogeneic stem cell transplant

• Clinical trial


Treatment guide

Stage IIB treatment

Widespread skin lesions

Chart 4.3.3

lists three treatment options for

widespread stage IIB cancers. One option is to treat

all skin lesions with total skin electron beam therapy.

If treatment works, you may receive immunotherapy

for a while to prolong the good results.

The second option is to treat the cancer with systemic

treatment. In addition, skin lesions may be treated

with skin treatment. Treatments in Group A won’t

suppress your immune system while treatments in

Group B and Group C will. Slower-growing cancers

may be treated with Group A and Group B treatments.

Group C treatments are preferred for cancers that

are growing fast. The large-cell transformed subtype

often, but not always, grows fast.

The third option for widespread stage IIB cancers is

combination treatment. Combination treatment may

consist of skin and systemic treatment. It may also

consist of two systemic treatments. Specific regimens

of combination treatment are listed in the chart.

If first-line treatment works, you may stay on your

treatment for a while or slowly stop treatment to

prolong the good results. Start treatment again if the

cancer was fully treated but came back as stage I

or II. People often have good results with the same

treatment. If a new treatment will be received, the

choice of which treatment will be partly based on

how much of your skin has lesions. If one or two

courses of first-line treatment didn’t work, try another

treatment listed in the chart.

You may have already tried multiple courses of first-

line treatment without much change. Sometimes,

despite treatment, the cancer may get worse. In either

case, second-line options are listed in Chart 4.3.4.

Chart 4.3.4

lists options for second-line treatment of

stage IIB cancers that were widespread at diagnosis.

There are three options. One option is multi-agent

chemotherapy. Another option is allogeneic stem cell

transplant. The third option is a clinical trial.