Initial treatment options for cutaneous T-cell lymphoma (CTCL) by stage.
| Stage . | Clinical Features . | Treatment Options . |
|---|---|---|
| Abbreviations: BSA, body surface area ; BCNU, carmustine; PUVA, phototherapy with ultraviolet A (UVA) with psoralen; IFN, interferon; ONTAK, denileukin diftitox. | ||
| † Topical Targretin may cause irritation if applied to a large body surface area. | ||
| 1A | Limited patch, plaque (<10% BSA) | Topical steroids, nitrogen mustard or BCNU, Targretin gel, spot electron beam irradiation |
| IB-IIA | Extensive patch, plaque (>10% BSA) | Topical nitrogen mustard or BCNU, PUVA, Targretin gel,† total skin electron beam irradiation, methotrexate, IFN, PUVA+ IFN, Targretin capsules |
| IIB | Tumors | Spot electron beam irradiation, PUVA +/- IFN, methotrexate, Targretin capsules, ONTAK |
| III | Erythroderma without Sézary cells | PUVA, total skin electron beam irradiation, topical nitrogen mustard or BCNU, Targretin capsules, IFN, PUVA + IFN, methotrexate, purine analogs |
| III | Erythroderma with Sézary cells | Extracorporeal photopheresis, PUVA + IFN, Targretin capsules, methotrexate, purine analogs, ONTAK |
| IV | Lymph node or visceral involvement | Skin-directed therapies plus Targretin capsules, IFN, ONTAK, purine analogs, cytotoxic chemotherapy |
| Stage . | Clinical Features . | Treatment Options . |
|---|---|---|
| Abbreviations: BSA, body surface area ; BCNU, carmustine; PUVA, phototherapy with ultraviolet A (UVA) with psoralen; IFN, interferon; ONTAK, denileukin diftitox. | ||
| † Topical Targretin may cause irritation if applied to a large body surface area. | ||
| 1A | Limited patch, plaque (<10% BSA) | Topical steroids, nitrogen mustard or BCNU, Targretin gel, spot electron beam irradiation |
| IB-IIA | Extensive patch, plaque (>10% BSA) | Topical nitrogen mustard or BCNU, PUVA, Targretin gel,† total skin electron beam irradiation, methotrexate, IFN, PUVA+ IFN, Targretin capsules |
| IIB | Tumors | Spot electron beam irradiation, PUVA +/- IFN, methotrexate, Targretin capsules, ONTAK |
| III | Erythroderma without Sézary cells | PUVA, total skin electron beam irradiation, topical nitrogen mustard or BCNU, Targretin capsules, IFN, PUVA + IFN, methotrexate, purine analogs |
| III | Erythroderma with Sézary cells | Extracorporeal photopheresis, PUVA + IFN, Targretin capsules, methotrexate, purine analogs, ONTAK |
| IV | Lymph node or visceral involvement | Skin-directed therapies plus Targretin capsules, IFN, ONTAK, purine analogs, cytotoxic chemotherapy |