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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/pdqcis/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" alt="Cover of PDQ Cancer Information Summaries" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>PDQ Cancer Information Summaries [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK65878_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK65878_dtls__"><div>Bethesda (MD): <a href="http://www.cancer.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Cancer Institute (US)</a>; 2002-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/pdqcis/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK65878_"><span class="title" itemprop="name">Mycosis Fungoides (Including Sézary Syndrome) Treatment (PDQ®)</span></h1><div class="subtitle whole_rhythm">Patient Version</div><p class="contrib-group"><span itemprop="author">PDQ Adult Treatment Editorial Board</span>.</p><p class="small">Published online: March 25, 2022.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000258022__183">This PDQ cancer information summary has current information about the treatment of mycosis fungoides (including Sézary Syndrome). It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p><p id="CDR0000258022__184">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.</p></div><div id="CDR0000258022__1"><h2 id="_CDR0000258022__1_">General Information About Mycosis Fungoides (Including Sézary Syndrome) </h2><div id="CDR0000258022__1.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000258022__3">Mycosis fungoides and Sézary syndrome are diseases in which
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lymphocytes (a type of white blood cell) become malignant
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(cancerous) and affect the skin.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258022__9">Mycosis fungoides and Sézary syndrome are types of cutaneous T-cell lymphoma. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000258022__13">A sign of mycosis fungoides is a red rash on the skin.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258022__125">In Sézary syndrome, cancerous T-cells are found in the blood.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258022__16">Tests that examine the skin and blood are used to diagnose mycosis fungoides and Sézary syndrome.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258022__20">Certain factors affect prognosis (chance
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of recovery) and treatment options.</a></div></li></ul></div><div id="CDR0000258022__3"><h3>Mycosis fungoides and Sézary syndrome are diseases in which
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lymphocytes (a type of white blood cell) become malignant
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(cancerous) and affect the skin.</h3><p id="CDR0000258022__121">Normally, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045622/" class="def">bone marrow</a> makes <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000765906/" class="def">blood stem cells</a> (immature <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a>) that become mature blood stem cells over time. A blood stem cell may become a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046279/" class="def">myeloid</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046598/" class="def">stem cell</a> or a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046298/" class="def">lymphoid</a> stem cell. A myeloid stem cell becomes a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046124/" class="def">red blood cell</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045993/" class="def">white blood cell</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045840/" class="def">platelet</a>. A lymphoid stem cell becomes a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000302475/" class="def">lymphoblast</a> and then one of three types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045765/" class="def">lymphocytes</a> (white blood cells):</p><ul id="CDR0000258022__122"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045611/" class="def">B-cell</a> lymphocytes that make <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044918/" class="def">antibodies</a> to help fight <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infection</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044928/" class="def">T-cell</a> lymphocytes that help <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044953/" class="def">B-lymphocytes</a> make the antibodies that help fight infection.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044062/" class="def">Natural killer cells</a> that attack <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> cells and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045941/" class="def">viruses</a>.</div></li></ul><div id="CDR0000258022__145" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Blood%20cell%20development&p=BOOKS&id=579041_CDR0000526538.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65878/bin/CDR0000526538.jpg" alt="Blood cell development; drawing shows the steps a blood stem cell goes through to become a red blood cell, platelet, or white blood cell. A myeloid stem cell becomes a red blood cell, a platelet, or a myeloblast, which then becomes a granulocyte (the types of granulocytes are eosinophils, basophils, and neutrophils). A lymphoid stem cell becomes a lymphoblast and then becomes a B-lymphocyte, T-lymphocyte, or natural killer cell." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Blood cell development. A blood stem cell goes through several steps to become a red blood cell, platelet, or white blood cell. </p></div></div><p id="CDR0000258022__123">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045794/" class="def">mycosis fungoides</a>, T-cell lymphocytes become cancerous and affect the skin. When these lymphocytes occur in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>, they are called Sézary cells. In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045878/" class="def">Sézary syndrome</a>, cancerous T-cell lymphocytes affect the skin and large numbers of Sézary cells are found in the blood.</p></div><div id="CDR0000258022__9"><h3>Mycosis fungoides and Sézary syndrome are types of cutaneous T-cell lymphoma. </h3><p id="CDR0000258022__11"> Mycosis fungoides and Sézary syndrome are the two most common types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046112/" class="def">cutaneous</a> T-cell
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045368/" class="def">lymphoma</a> (a type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045148/" class="def">non-Hodgkin lymphoma</a>). For information about other types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000445084/" class="def">skin cancer</a> or non-Hodgkin lymphoma, see the following <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a> summaries:</p><ul id="CDR0000258022__106"><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/CDR0000062958/">Adult Non-Hodgkin Lymphoma Treatment</a>
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</div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/CDR0000258035/">Skin Cancer Treatment</a>
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</div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/CDR0000062713/">Melanoma Treatment</a>
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</div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/CDR0000442381/">Kaposi Sarcoma Treatment</a>
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</div></li></ul></div><div id="CDR0000258022__13"><h3>A sign of mycosis fungoides is a red rash on the skin.</h3><p id="CDR0000258022__108">Mycosis fungoides may go through the following phases:</p><ul id="CDR0000258022__124"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439417/" class="def">Premycotic phase</a>: A scaly, red rash in areas of the body that usually are not exposed to the sun. This rash does not cause <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and may last for months or years. It is hard to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> the rash as mycosis fungoides during this phase.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000729587/" class="def">Patch</a> phase: Thin, reddened, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000462675/" class="def">eczema</a>-like rash.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439411/" class="def">Plaque</a> phase: Small raised bumps (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000729589/" class="def">papules</a>) or hardened <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046324/" class="def">lesions</a> on the skin, which may be reddened. </div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">Tumor</a> phase: Tumors form on the skin. These tumors may develop <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269469/" class="def">ulcers</a> and the skin may get infected.</div></li></ul><p id="CDR0000258022__173">Check with your doctor if you have any of these <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a>.</p></div><div id="CDR0000258022__125"><h3>In Sézary syndrome, cancerous T-cells are found in the blood.</h3><p id="CDR0000258022__127">Also, skin all over the body is reddened, itchy, peeling, and painful. There may also be patches, plaques, or tumors on the skin. It is not known if Sézary syndrome is an advanced form of mycosis fungoides or a separate disease.</p></div><div id="CDR0000258022__16"><h3>Tests that examine the skin and blood are used to diagnose mycosis fungoides and Sézary syndrome.</h3><p id="CDR0000258022__18">The following tests and procedures may be used:</p><ul id="CDR0000258022__19"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270871/" class="def">Physical exam</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000798522/" class="def">health history</a></b>: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps, the number and type of skin lesions, or anything else that seems unusual. Pictures of the skin and a history of the patient’s health habits and past illnesses and treatments will also be taken.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000729979/" class="def">Complete blood count with differential</a></b>: A procedure in which a sample of blood is drawn and checked for the following:
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<dl id="CDR0000258022__114" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">The number of red blood cells and platelets.</p></dd><dt>-</dt><dd><p class="no_top_margin">The number and type of white blood cells.</p></dd><dt>-</dt><dd><p class="no_top_margin">The amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045108/" class="def">hemoglobin</a> (the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">protein</a> that carries <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000538149/" class="def">oxygen</a>) in the red blood cells.
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</p></dd><dt>-</dt><dd><p class="no_top_margin">The portion of the blood sample made up of red blood cells.
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</p></dd></dl><div id="CDR0000258022__140" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Complete%20blood%20count%20(CBC)&p=BOOKS&id=579041_CDR0000526546.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65878/bin/CDR0000526546.jpg" alt="Complete blood count (CBC); left panel shows blood being drawn from a vein on the inside of the elbow using a tube attached to a syringe; right panel shows a laboratory test tube with blood cells separated into layers: plasma, white blood cells, platelets, and red blood cells." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Complete blood count (CBC). Blood is collected by inserting a needle into a vein and allowing the blood to flow into a tube. The blood sample is sent to the laboratory and the red blood cells, white blood cells, and platelets are counted. The CBC is used to test for, diagnose, and monitor many different conditions.</p></div></div></div></li><li class="half_rhythm"><div><b>Sézary blood cell count</b>: A procedure in which a sample of blood is viewed under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> to count the number of Sézary cells.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000759626/" class="def">HIV test</a></b>: A test to measure the level of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045711/" class="def">HIV antibodies</a> in a sample of blood. Antibodies are made by the body when it is invaded by a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000698772/" class="def">foreign</a> substance. A high level of HIV antibodies may mean the body has been infected with HIV.</div></li><li class="half_rhythm"><div><b>Skin <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045164/" class="def">biopsy</a></b>: The removal of cells or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissues</a> so they can be viewed under a microscope to check for signs of cancer. The doctor may remove a growth from the skin, which will be examined by a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a>. More than one skin biopsy may be needed to diagnose mycosis fungoides. Other tests that may be done on the cells or tissue sample include the following:<ul id="CDR0000258022__210"><li class="half_rhythm"><div>
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<b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000341450/" class="def">Immunophenotyping</a></b>: A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046590/" class="def">laboratory test</a> that uses antibodies to identify cancer cells based on the types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046086/" class="def">antigens</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045776/" class="def">markers</a> on the surface of the cells. This test is used to help diagnose specific types of lymphoma.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000335066/" class="def">Flow cytometry</a></b>: A laboratory test that measures the number of cells in a sample, the percentage of live cells in a sample, and certain characteristics of the cells, such as size, shape, and the presence of tumor (or other) <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046636/" class="def">markers</a> on the cell surface. The cells from a sample of a patient’s blood, bone marrow, or other tissue are stained with a fluorescent dye, placed in a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044669/" class="def">fluid</a>, and then passed one at a time through a beam of light. The test results are based on how the cells that were stained with the fluorescent dye react to the beam of light. This test is used to help diagnose and manage certain types of cancers, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045343/" class="def">leukemia</a> and lymphoma.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000780791/" class="def">T-cell receptor (TCR) gene rearrangement test</a></b>: A laboratory test in which cells in a sample of blood or bone marrow are checked to see if there are certain changes in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045693/" class="def">genes</a> that make <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044958/" class="def">receptors</a> on T cells (white blood cells). Testing for these gene changes can tell whether large numbers of T cells with a certain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000787980/" class="def">T-cell receptor</a> are being made.</div></li></ul></div></li></ul></div><div id="CDR0000258022__20"><h3>Certain factors affect prognosis (chance
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of recovery) and treatment options.</h3><p id="CDR0000258022__103">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045849/" class="def">prognosis</a> and treatment options depend on the following: </p><ul id="CDR0000258022__104"><li class="half_rhythm"><div>The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer.</div></li><li class="half_rhythm"><div>The type of lesion (patches, plaques, or tumors).</div></li><li class="half_rhythm"><div>The patient's age and gender.</div></li></ul><p id="CDR0000258022__119">Mycosis fungoides and Sézary syndrome are hard to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000318813/" class="def">cure</a>. Treatment is usually <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative</a>, to relieve symptoms and improve the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>. Patients with early stage disease may live many years.</p></div></div><div id="CDR0000258022__26"><h2 id="_CDR0000258022__26_">Stages of Mycosis Fungoides (Including Sézary Syndrome) </h2><div id="CDR0000258022__26.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000258022__27">After mycosis fungoides and Sézary syndrome have been
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diagnosed, tests are done to find out if cancer cells have spread from the skin to other parts of the body. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000258022__146">There are three ways that cancer spreads in the body.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258022__179">Cancer may spread from where it began to other parts of the body.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258022__31">The following stages are used for mycosis fungoides and
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Sézary syndrome:</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000258022__33">Stage I Mycosis Fungoides</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258022__37">Stage II Mycosis Fungoides</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258022__41">Stage III Mycosis Fungoides</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258022__221">Stage IV Mycosis Fungoides/Sézary Syndrome</a></div></li></ul></li><li class="half_rhythm"><div><a href="#CDR0000258022__249">Mycosis fungoides and
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Sézary syndrome can recur
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(come back) after they have been treated.</a></div></li></ul></div><div id="CDR0000258022__27"><h3>After mycosis fungoides and Sézary syndrome have been
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diagnosed, tests are done to find out if cancer cells have spread from the skin to other parts of the body. </h3><p id="CDR0000258022__29">The process used to find out if <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread from the skin to other parts
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of the body is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046597/" class="def">staging</a>. The
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information gathered from the staging process determines the
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the disease. It is
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important to know the stage in order to plan treatment. </p><p id="CDR0000258022__182">The following
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procedures may be used in the staging process:</p><ul id="CDR0000258022__30"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000304687/" class="def">Chest x-ray</a></b>: An <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-ray</a> of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046033/" class="def">CT scan</a> (CAT scan)</b>: A procedure that makes a series of detailed pictures of areas inside the body, such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>, chest, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046246/" class="def">pelvis</a>, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000409764/" class="def">dye</a> may be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or swallowed to help the organs or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissues</a> show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. </div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046140/" class="def">PET scan</a> (positron emission tomography scan)</b>: A procedure to find <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045772/" class="def">malignant</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> in the body. A small amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044033/" class="def">glucose</a> (sugar) is injected into a vein. The PET <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386220/" class="def">scanner</a> rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.</div></li><li class="half_rhythm"><div>
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<b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000793499/" class="def">Lymph node biopsy</a></b>: The removal of all or part of a lymph node. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a> views the lymph node tissue under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> to check for cancer cells.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000669655/" class="def">Bone marrow aspiration and biopsy</a></b>: The removal of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045622/" class="def">bone marrow</a> and a small piece of bone by inserting a hollow needle into the hipbone or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000549425/" class="def">breastbone</a>. A pathologist views the bone marrow and bone under a microscope to look for signs of cancer.</div></li></ul></div><div id="CDR0000258022__146"><h3>There are three ways that cancer spreads in the body.</h3><p id="CDR0000258022__146_md_69">Cancer can spread through <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045764/" class="def">lymph system</a>, and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>:</p><ul id="CDR0000258022__146_md_70"><li class="half_rhythm"><div>Tissue. The cancer spreads from where it began by growing into nearby areas.
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</div></li><li class="half_rhythm"><div>Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269462/" class="def">lymph vessels</a> to other parts of the body.
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</div></li><li class="half_rhythm"><div>Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a> to other parts of the body.
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</div></li></ul></div><div id="CDR0000258022__179"><h3>Cancer may spread from where it began to other parts of the body.</h3><p id="CDR0000258022__179_md_66">When cancer spreads to another part of the body, it is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046710/" class="def">metastasis</a>. Cancer cells break away from where they began (the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045847/" class="def">primary tumor</a>) and travel through the lymph system or blood.</p><ul id="CDR0000258022__179_md_67"><li class="half_rhythm"><div>Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044058/" class="def">metastatic</a> tumor) in another part of the body.</div></li><li class="half_rhythm"><div>Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.</div></li></ul><p id="CDR0000258022__181">The metastatic tumor is the same type of cancer as the primary tumor. For example, if <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045794/" class="def">mycosis fungoides</a> spreads to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046312/" class="def">liver</a>, the cancer cells in the liver are actually mycosis fungoides cells. The disease is metastatic mycosis fungoides, not liver cancer.</p><div id="CDR0000258022__195" class="box"><h3><span class="title">metastasis: how cancer spreads</span></h3><div class="caption"><p>Many cancer deaths are caused when cancer moves from the original tumor and spreads to other tissues and organs. This is called metastatic cancer. This animation shows how cancer cells travel from the place in the body where they first formed to other parts of the body.</p></div><p><a href="https://www.youtube.com/watch?v=fQwar_-QdiQ" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">YouTube</a></p></div></div><div id="CDR0000258022__31"><h3>The following stages are used for mycosis fungoides and
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Sézary syndrome:</h3><div id="CDR0000258022__33"><h4>Stage I Mycosis Fungoides</h4><p id="CDR0000258022__211"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454834/" class="def">Stage I</a> is divided into stages IA and IB as follows:</p><ul id="CDR0000258022__212"><li class="half_rhythm"><div>Stage IA: <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000729587/" class="def">Patches</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000729589/" class="def">papules</a>, and/or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439411/" class="def">plaques</a> cover less than 10% of the skin surface.</div></li><li class="half_rhythm"><div>Stage IB: Patches, papules, and/or plaques cover 10% or more of the skin surface.</div></li></ul><p id="CDR0000258022__213">There may be a low number of Sézary <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>.</p></div><div id="CDR0000258022__37"><h4>Stage II Mycosis Fungoides</h4><p id="CDR0000258022__214"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454837/" class="def">Stage II</a> is divided into stages IIA and IIB as follows:</p><ul id="CDR0000258022__215"><li class="half_rhythm"><div>Stage IIA: <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000729587/" class="def">Patches</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000729589/" class="def">papules</a>, and/or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439411/" class="def">plaques</a> cover any amount of skin surface. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">Lymph nodes</a> are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a>, but they are not cancerous.</div></li><li class="half_rhythm"><div> Stage IIB: One or more <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a> that are 1 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeter</a> or larger are found on the skin. Lymph nodes may be abnormal, but they are not cancerous.</div></li></ul><p id="CDR0000258022__216">There may be a low number of Sézary <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>.</p></div><div id="CDR0000258022__41"><h4>Stage III Mycosis Fungoides</h4><p id="CDR0000258022__217">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454840/" class="def">stage III</a>, 80% or more of the skin surface is reddened and may have <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000729587/" class="def">patches</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000729589/" class="def">papules</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439411/" class="def">plaques</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a>. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">Lymph nodes</a> may be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a>, but they are not cancerous.</p><p id="CDR0000258022__218">There may be a low number of Sézary <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>.</p></div><div id="CDR0000258022__221"><h4>Stage IV Mycosis Fungoides/Sézary Syndrome</h4><p id="CDR0000258022__223">When there is a high number of Sézary cells in the blood, the disease is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045878/" class="def">Sézary syndrome</a>.</p><p id="CDR0000258022__219"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454841/" class="def">Stage IV</a> is divided into stages IVA1, IVA2, and IVB as follows:</p><ul id="CDR0000258022__220"><li class="half_rhythm"><div>Stage IVA1: <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000729587/" class="def">Patches</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000729589/" class="def">papules</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439411/" class="def">plaques</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a> may cover any amount of the skin surface, and 80% or more of the skin surface may be reddened. The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> may be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a>, but they are not cancerous. There is a high number of Sézary <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>.</div></li><li class="half_rhythm"><div>Stage IVA2: Patches, papules, plaques, or tumors may cover any amount of the skin surface, and 80% or more of the skin surface may be reddened. The lymph nodes are very abnormal, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has formed in the lymph nodes. There may be a high number of Sézary cells in the blood.</div></li><li class="half_rhythm"><div>Stage IVB: Cancer has spread to other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> in the body, such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046593/" class="def">spleen</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046312/" class="def">liver</a>. Patches, papules, plaques, or tumors may cover any amount of the skin surface, and 80% or more of the skin surface may be reddened. The lymph nodes may be abnormal or cancerous. There may be a high number of Sézary cells in the blood.</div></li></ul></div></div><div id="CDR0000258022__249"><h3>Mycosis fungoides and
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Sézary syndrome can recur
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(come back) after they have been treated.</h3><p id="CDR0000258022__251">Mycosis fungoides and
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045878/" class="def">Sézary syndrome</a> may come back
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in the skin or in other parts of the body, such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046593/" class="def">spleen</a> or liver.</p></div></div><div id="CDR0000258022__50"><h2 id="_CDR0000258022__50_">Treatment Option Overview</h2><div id="CDR0000258022__50.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000258022__51">There are different types of treatment for patients with
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mycosis fungoides and Sézary syndrome cancer. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000258022__233">Seven types of standard treatment are used:</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000258022__57">Photodynamic therapy
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</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258022__60">Radiation therapy</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258022__63">Chemotherapy </a></div></li><li class="half_rhythm"><div><a href="#CDR0000258022__134">Other drug therapy</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258022__135">Immunotherapy</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258022__225">Targeted therapy</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258022__230">High-dose chemotherapy and radiation therapy with stem cell transplant</a></div></li></ul></li><li class="half_rhythm"><div><a href="#CDR0000258022__72">New types of treatment are being tested in clinical
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trials. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000258022__196">Treatment for mycosis fungoides and Sézary syndrome may cause side effects.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258022__148">Patients may want to think about taking part in a clinical trial.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258022__150">Patients can enter clinical trials before, during, or after starting their cancer treatment.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258022__152">Follow-up tests may be needed.</a></div></li></ul></div><div id="CDR0000258022__51"><h3>There are different types of treatment for patients with
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mycosis fungoides and Sézary syndrome cancer. </h3><p id="CDR0000258022__53">Different types of treatment are available for patients with
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045794/" class="def">mycosis fungoides</a> and
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045878/" class="def">Sézary syndrome</a>. Some treatments are
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard</a> (the currently used treatment), and some are being tested in
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trials</a>. A
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treatment clinical trial is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651211/" class="def">research study</a> meant to help improve current
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treatments or obtain information on new treatments for patients with
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>. When clinical trials show that
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a new treatment is better than the standard
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treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
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</p></div><div id="CDR0000258022__233"><h3>Seven types of standard treatment are used:</h3><div id="CDR0000258022__57"><h4>Photodynamic therapy
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</h4><p id="CDR0000258022__120"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045238/" class="def">Photodynamic therapy</a> is a cancer treatment that uses a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drug</a> and a certain type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045748/" class="def">laser</a> light to kill cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a>. A drug that is not active until it is exposed to light is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a>. The drug collects more in cancer cells than in normal cells. For <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000445084/" class="def">skin cancer</a>, laser light is shined onto the skin and the drug becomes active and kills the cancer cells. Photodynamic therapy causes little damage to healthy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>. Patients undergoing photodynamic therapy will need to limit the amount of time spent in sunlight. There are different types of photodynamic therapy:</p><ul id="CDR0000258022__224"><li class="half_rhythm"><div>In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439423/" class="def">psoralen and ultraviolet A (PUVA) therapy</a>, the patient receives a drug
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called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044900/" class="def">psoralen</a> and then
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000666694/" class="def">ultraviolet A radiation</a> is directed to
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the skin. </div></li><li class="half_rhythm"><div>In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000403135/" class="def">extracorporeal photopheresis</a> (ECP), the patient is given drugs and then some <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a> cells are
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taken from the body, put under a special <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046700/" class="def">ultraviolet A light</a>, and put back into the body. ECP may be used alone or combined with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439430/" class="def">total skin electron beam (TSEB) radiation therapy</a>.</div></li></ul></div><div id="CDR0000258022__60"><h4>Radiation therapy</h4><p id="CDR0000258022__110"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> is a cancer treatment that uses high-energy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-rays</a> or other types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045072/" class="def">radiation</a> to kill cancer cells or keep them from growing. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a> uses a machine outside the body to send radiation toward the area of the body with cancer. Sometimes, total skin electron beam (TSEB) radiation therapy is used to treat mycosis fungoides and Sézary syndrome. This is a type of external radiation treatment in which a radiation therapy machine aims <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000702062/" class="def">electrons</a> (tiny, invisible particles) at the skin covering the whole body. External radiation therapy may also be used as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative therapy</a> to relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and improve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>. </p><p id="CDR0000258022__185"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000666694/" class="def">Ultraviolet A (UVA) radiation therapy</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046700/" class="def">ultraviolet B (UVB) radiation therapy</a> may be given using a special lamp or laser that directs radiation at the skin.</p></div><div id="CDR0000258022__63"><h4>Chemotherapy </h4><p id="CDR0000258022__111"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000301626/" class="def">systemic chemotherapy</a>). Sometimes the chemotherapy is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045927/" class="def">topical</a>
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(put on the skin in a cream, lotion, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000508685/" class="def">ointment</a>). </p><p id="CDR0000258022__165">See <a href="https://www.cancer.gov/about-cancer/treatment/drugs/non-hodgkin" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Non-Hodgkin Lymphoma</a> for more information. (Mycosis fungoides and Sézary syndrome are types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045148/" class="def">non-Hodgkin lymphoma</a>.)</p></div><div id="CDR0000258022__134"><h4>Other drug therapy</h4><p id="CDR0000258022__137"> Topical <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045658/" class="def">corticosteroids</a> are used to relieve red, swollen, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044042/" class="def">inflamed</a> skin. They are a type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000613764/" class="def">steroid</a>. Topical corticosteroids may be in a cream, lotion, or ointment.</p><p id="CDR0000258022__112"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045870/" class="def">Retinoids</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045423/" class="def">bexarotene</a>, are drugs related to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045248/" class="def">vitamin A</a> that can slow the growth of certain types of cancer cells. The retinoids may be taken by mouth or put on the skin.</p><p id="CDR0000258022__200"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000393761/" class="def">Lenalidomide</a> is a drug that helps the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune system</a> kill <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a> blood cells or cancer cells and may prevent the growth of new <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a> that tumors need to grow.</p><p id="CDR0000258022__201">
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000455153/" class="def">Vorinostat</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000509038/" class="def">romidepsin</a> are two of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000472896/" class="def">histone deacetylase (HDAC) inhibitors</a> used to treat mycosis fungoides and Sézary syndrome. HDAC inhibitors cause a chemical change that stops tumor cells from dividing.</p><p id="CDR0000258022__169">See <a href="https://www.cancer.gov/about-cancer/treatment/drugs/non-hodgkin" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Non-Hodgkin Lymphoma</a> for more information. (Mycosis fungoides and Sézary syndrome are types of non-Hodgkin lymphoma.)</p></div><div id="CDR0000258022__135"><h4>Immunotherapy</h4><p id="CDR0000258022__131"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045729/" class="def">Immunotherapy</a> is a treatment that uses the patient's <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune system</a> to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This cancer treatment is a type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045617/" class="def">biologic therapy</a>.</p><ul id="CDR0000258022__239"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045324/" class="def">Interferon</a>: This treatment interferes with the division of mycosis
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fungoides and Sézary cells and can slow
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> growth.</div></li></ul><p id="CDR0000258022__166">See <a href="https://www.cancer.gov/about-cancer/treatment/drugs/non-hodgkin" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Non-Hodgkin Lymphoma</a> for more information. (Mycosis fungoides and Sézary syndrome are types of non-Hodgkin lymphoma.)</p></div><div id="CDR0000258022__225"><h4>Targeted therapy</h4><p id="CDR0000258022__227"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells. Targeted therapies usually cause less harm to normal cells than chemotherapy or radiation therapy do.</p><ul id="CDR0000258022__240"><li class="half_rhythm"><div class="half_rhythm">
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046066/" class="def">Monoclonal antibodies</a>: Monoclonal antibodies are immune system <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">proteins</a> made in the laboratory to treat many diseases, including cancer. As a cancer treatment, these <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044918/" class="def">antibodies</a> can attach to a specific target on cancer cells or other cells that may help cancer cells grow. The antibodies are able to then kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045738/" class="def">infusion</a>. They may be used alone or to carry drugs, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046622/" class="def">toxins</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> material directly to cancer cells.</div><div class="half_rhythm">Types of monoclonal antibodies include:<ul id="CDR0000258022__236"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000710543/" class="def">Brentuximab vedotin</a>, which contains a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046066/" class="def">monoclonal antibody</a> that binds to a protein, called CD30, found on some types of lymphoma cells. It also contains an anticancer drug that may help kill cancer cells.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000794274/" class="def">Mogamulizumab</a>, which contains a monoclonal antibody that binds to a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">protein</a>, called CCR4, found on some types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045368/" class="def">lymphoma</a> cells. It may block this protein and help the immune system kill cancer cells. It is used to treat mycosis fungoides and Sézary syndrome that came back or did not get better after treatment with at least one <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045922/" class="def">systemic therapy</a>. </div></li></ul><div id="CDR0000258022__252" class="box"><h3><span class="title">monoclonal antibodies: how monoclonal antibodies treat cancer</span></h3><div class="caption"><p>How do monoclonal antibodies work to treat cancer? This video shows how monoclonal antibodies, such as trastuzumab, pembrolizumab, and rituximab, block molecules cancer cells need to grow, flag cancer cells for destruction by the body’s immune system, or deliver harmful substances to cancer cells. </p></div><p><a href="https://www.youtube.com/watch?v=dxnjAc-rqz8" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">YouTube</a></p></div></div></li></ul></div><div id="CDR0000258022__230"><h4>High-dose chemotherapy and radiation therapy with stem cell transplant</h4><p id="CDR0000258022__232">High <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044664/" class="def">doses</a> of chemotherapy and sometimes radiation therapy are given to kill cancer cells. Healthy cells, including blood-forming cells, are also destroyed by the cancer treatment. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046695/" class="def">Stem cell transplant</a> is a treatment to replace the blood-forming cells. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046598/" class="def">Stem cells</a> (immature blood cells) are removed from the blood or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045622/" class="def">bone marrow</a> of the patient or a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000643010/" class="def">donor</a> and are frozen and stored. After the patient completes chemotherapy and radiation therapy, the stored stem cells are thawed and given back to the patient through an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045738/" class="def">infusion</a>. These reinfused stem cells grow into (and restore) the body's blood cells.</p></div></div><div id="CDR0000258022__72"><h3>New types of treatment are being tested in clinical
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trials. </h3><p id="CDR0000258022__370">This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p><div id="CDR0000258022__371"><h4>Immune checkpoint inhibitor therapy</h4><ul id="CDR0000258022__374"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000772606/" class="def">Immune checkpoint inhibitor</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044737/" class="def">therapy</a>: Immune checkpoint inhibitors block <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">proteins</a> called checkpoints that are made by some types of immune system cells, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044928/" class="def">T cells</a>, and some cancer cells. These checkpoints help keep <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045722/" class="def">immune responses</a> from being too strong and sometimes can keep T cells from killing cancer cells. When these checkpoints are blocked, T cells can kill cancer cells better.</div></li></ul><ul id="CDR0000258022__375"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000777027/" class="def">PD-1</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000797389/" class="def">PD-L1</a> inhibitor therapy: PD-1 is a protein on the surface of T cells that helps keep the body’s immune responses in check. PD-L1 is a protein found on some types of cancer cells. When PD-1 attaches to PD-L1, it stops the T cell from killing the cancer cell. PD-1 and PD-L1 inhibitors keep PD-1 and PD-L1 proteins from attaching to each other. This allows the T cells to kill cancer cells. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000764538/" class="def">Pembrolizumab</a> is a type of PD-1 inhibitor.</div></li></ul><div id="CDR0000258022__331" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Immune%20checkpoint%20inhibitor&p=BOOKS&id=579041_CDR0000774646.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65878/bin/CDR0000774646.jpg" alt="Immune checkpoint inhibitor; the panel on the left shows the binding of proteins PD-L1 (on the tumor cell) to PD-1 (on the T cell), which keeps T cells from killing tumor cells in the body. Also shown are a tumor cell antigen and T cell receptor. The panel on the right shows immune checkpoint inhibitors (anti-PD-L1 and anti-PD-1) blocking the binding of PD-L1 to PD-1, which allows the T cells to kill tumor cells." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Immune checkpoint inhibitor. Checkpoint proteins, such as PD-L1 on tumor cells and PD-1 on T cells, help keep immune responses in check. The binding of PD-L1 to PD-1 keeps T cells from killing tumor cells in the body (left panel). Blocking the binding of PD-L1 to PD-1 with an immune checkpoint inhibitor (anti-PD-L1 or anti-PD-1) allows the T cells to kill tumor cells (right panel).</p></div></div><div id="CDR0000258022__369" class="box"><h3><span class="title">immune checkpoint inhibitors</span></h3><div class="caption"><p>Immunotherapy uses the body’s immune system to fight cancer. This animation explains one type of immunotherapy that uses immune checkpoint inhibitors to treat cancer.</p></div><p><a href="https://www.youtube.com/watch?v=GIUu239FWMg" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">YouTube</a></p></div><p id="CDR0000258022__144">Information about clinical trials is available from the <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div></div><div id="CDR0000258022__196"><h3>Treatment for mycosis fungoides and Sézary syndrome may cause side effects.</h3><p id="CDR0000258022__196_md_73">For information about <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> caused by treatment for cancer, visit our <a href="https://www.cancer.gov/about-cancer/treatment/side-effects" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Side Effects</a> page.</p></div><div id="CDR0000258022__148"><h3>Patients may want to think about taking part in a clinical trial.</h3><p id="CDR0000258022__148_md_23">For some patients, taking part in a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard treatment</a>.</p><p id="CDR0000258022__148_md_24">Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.</p><p id="CDR0000258022__148_md_25">Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.</p></div><div id="CDR0000258022__150"><h3>Patients can enter clinical trials before, during, or after starting their cancer treatment.</h3><p id="CDR0000258022__150_md_29">Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> of cancer treatment.</p><p id="CDR0000258022__150_md_30">Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s <a href="https://www.cancer.gov/research/participate/clinical-trials-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trials search</a> webpage. Clinical trials supported by other organizations can be found on the <a href="https://clinicaltrials.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">ClinicalTrials.gov</a> website.</p></div><div id="CDR0000258022__152"><h3>Follow-up tests may be needed.</h3><p id="CDR0000258022__152_md_33">As you go through treatment, you will have follow-up tests or check-ups. Some tests that were done to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> the cancer may be repeated to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.</p><p id="CDR0000258022__152_md_34">Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). </p></div></div><div id="CDR0000258022__241"><h2 id="_CDR0000258022__241_">Treatment of Stage I and Stage II Mycosis Fungoides</h2><p id="CDR0000258022__248">For information about the treatments listed below, see the <a href="#CDR0000258022__233">Treatment Option Overview</a> section.</p><p id="CDR0000258022__81">Treatment of newly diagnosed <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454834/" class="def">stage I</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454837/" class="def">stage II</a> mycosis fungoides may include the following:</p><ul id="CDR0000258022__189"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439423/" class="def">Psoralen and ultraviolet A (PUVA) radiation therapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000666695/" class="def">Ultraviolet B radiation</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044737/" class="def">therapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439430/" class="def">total skin electron beam radiation therapy</a>. In some cases, radiation therapy is given to skin <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046324/" class="def">lesions</a>, as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative therapy</a> to reduce <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> size to relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and improve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045729/" class="def">Immunotherapy</a> given alone or combined with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044737/" class="def">therapy</a> directed at the skin.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046619/" class="def">Topical chemotherapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000301626/" class="def">Systemic chemotherapy</a> with one or more <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a>, which may be combined with therapy directed at the skin.</div></li><li class="half_rhythm"><div>Other drug therapy (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045927/" class="def">topical</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045658/" class="def">corticosteroids</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045870/" class="def">retinoid</a> therapy, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000393761/" class="def">lenalidomide</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000472896/" class="def">histone deacetylase inhibitors</a>).</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000710543/" class="def">brentuximab vedotin</a>).</div></li></ul><p id="CDR0000258022__TrialSearch_241_19">Use our <a href="https://www.cancer.gov/research/participate/clinical-trials-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000258022__242"><h2 id="_CDR0000258022__242_">Treatment of Stage III and Stage IV Mycosis Fungoides (Including Sézary Syndrome)</h2><p id="CDR0000258022__237">For information about the treatments listed below, see the <a href="#CDR0000258022__233">Treatment Option Overview</a> section.</p><p id="CDR0000258022__87">Treatment of newly diagnosed <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454840/" class="def">stage III</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454841/" class="def">stage IV</a> mycosis fungoides
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including Sézary syndrome is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative</a> (to relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and improve the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>) and may include the following:</p><ul id="CDR0000258022__243"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439423/" class="def">Psoralen and ultraviolet A (PUVA) radiation therapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000666695/" class="def">Ultraviolet B radiation</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044737/" class="def">therapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000403135/" class="def">Extracorporeal photopheresis</a> (ECP) given alone or combined with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439430/" class="def">total skin electron beam radiation therapy</a>.</div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> with total skin electron beam radiation therapy. In some cases, radiation therapy is given to skin <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046324/" class="def">lesions</a>, as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative therapy</a> to reduce <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> size to relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and improve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045729/" class="def">Immunotherapy</a> given alone or combined with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044737/" class="def">therapy</a> directed at the skin.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000301626/" class="def">Systemic chemotherapy</a> with one or more <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a>, which may be combined with therapy directed at the skin. </div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046619/" class="def">Topical chemotherapy</a>.</div></li><li class="half_rhythm"><div>Other drug therapy (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045927/" class="def">topical</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045658/" class="def">corticosteroids</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000393761/" class="def">lenalidomide</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045423/" class="def">bexarotene</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000472896/" class="def">histone deacetylase inhibitors</a>).</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000710543/" class="def">brentuximab vedotin</a>.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000772606/" class="def">immune checkpoint inhibitor</a> therapy with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000764538/" class="def">pembrolizumab</a>.</div></li></ul><p id="CDR0000258022__TrialSearch_242_19">Use our <a href="https://www.cancer.gov/research/participate/clinical-trials-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000258022__244"><h2 id="_CDR0000258022__244_">Treatment of Recurrent Mycosis Fungoides (Including Sézary Syndrome)</h2><p id="CDR0000258022__245">For information about the treatments listed below, see the <a href="#CDR0000258022__233">Treatment Option Overview</a> section.</p><p id="CDR0000258022__246">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurrent</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045794/" class="def">mycosis fungoides</a> including <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045878/" class="def">Sézary syndrome</a> may be within a clinical trial and may include the
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following:</p><ul id="CDR0000258022__247"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439430/" class="def">total skin electron beam radiation therapy</a>. In some cases, radiation therapy is given to skin <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046324/" class="def">lesions</a> as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative therapy</a> to reduce <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> size to relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and improve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439423/" class="def">Psoralen and ultraviolet A (PUVA) radiation therapy</a>, which may be given with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045729/" class="def">immunotherapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000666695/" class="def">Ultraviolet B radiation</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000403135/" class="def">Extracorporeal photopheresis</a> (ECP).</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000301626/" class="def">Systemic chemotherapy</a> with one or more <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a>.</div></li><li class="half_rhythm"><div>Other drug <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044737/" class="def">therapy</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045927/" class="def">topical</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045658/" class="def">corticosteroids</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045870/" class="def">retinoid</a> therapy, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000393761/" class="def">lenalidomide</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000472896/" class="def">histone deacetylase inhibitors</a>).</div></li><li class="half_rhythm"><div>Immunotherapy given alone or combined with therapy directed at the skin.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000346522/" class="def">High-dose chemotherapy</a>, and sometimes radiation therapy, with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046695/" class="def">stem cell transplant</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000710543/" class="def">brentuximab vedotin</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000794274/" class="def">mogamulizumab</a>).</div></li></ul><p id="CDR0000258022__TrialSearch_244_19">Use our <a href="https://www.cancer.gov/research/participate/clinical-trials-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000258022__141"><h2 id="_CDR0000258022__141_">To Learn More About Mycosis Fungoides and Sézary Syndrome</h2><p id="CDR0000258022__138">For more information from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044266/" class="def">National Cancer Institute</a> about mycosis fungoides and Sézary syndrome, see the following:</p><ul id="CDR0000258022__168"><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/types/lymphoma" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Lymphoma Home Page</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/treatment/types/photodynamic-therapy" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Photodynamic Therapy for Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/treatment/drugs/non-hodgkin" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Non-Hodgkin Lymphoma</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/treatment/types/immunotherapy" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Immunotherapy to Treat Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/treatment/types/targeted-therapies" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Targeted Cancer Therapies</a>
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</div></li></ul><p id="CDR0000258022__141_md_40">For general cancer information and other resources from the National Cancer Institute, visit:</p><ul id="CDR0000258022__141_md_41"><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">About Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/diagnosis-staging/staging" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cancer Staging</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/publications/patient-education/chemo-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Chemotherapy and You: Support for People With Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/publications/patient-education/radiation-therapy-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Radiation Therapy and You: Support for People With Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/coping" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Coping with Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/coping/questions" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Questions to Ask Your Doctor about Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://cancercontrol.cancer.gov/ocs/resources/survivors.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">For Survivors, Caregivers, and Advocates</a>
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</div></li></ul></div><div id="CDR0000258022__AboutThis_1"><h2 id="_CDR0000258022__AboutThis_1_">About This PDQ Summary</h2><div id="CDR0000258022__AboutThis_2"><h3>About PDQ</h3><p id="CDR0000258022__AboutThis_3">Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in <a href="https://www.cancer.gov/espanol/publicaciones/pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Spanish</a>.</p><p id="CDR0000258022__AboutThis_4">PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.</p></div><div id="CDR0000258022__AboutThis_5"><h3>Purpose of This Summary</h3><p id="CDR0000258022__AboutThis_6">This PDQ cancer information summary has current information about the treatment of mycosis fungoides (including Sézary Syndrome). It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p></div><div id="CDR0000258022__AboutThis_7"><h3>Reviewers and Updates</h3><p id="CDR0000258022__AboutThis_8">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.
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</p><p id="CDR0000258022__AboutThis_9">The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the <a href="https://www.cancer.gov/publications/pdq/editorial-boards/adult-treatment" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Adult Treatment Editorial Board</a>.
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</p></div><div id="CDR0000258022__AboutThis_10"><h3>Clinical Trial Information</h3><p id="CDR0000258022__AboutThis_11">A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
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</p><p id="CDR0000258022__AboutThis_12">Clinical trials can be found online at <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI's website</a>. For more information, call the <a href="https://www.cancer.gov/contact/contact-center" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cancer Information Service</a> (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).
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</p></div><div id="CDR0000258022__AboutThis_13"><h3>Permission to Use This Summary</h3><p id="CDR0000258022__AboutThis_14">PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
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</p><p id="CDR0000258022__AboutThis_15">The best way to cite this PDQ summary is:</p><p id="CDR0000258022__AboutThis_21">PDQ® Adult Treatment Editorial Board. PDQ Mycosis Fungoides (Including Sézary Syndrome) Treatment. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: <a href="https://www.cancer.gov/types/lymphoma/patient/mycosis-fungoides-treatment-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www.cancer.gov/types/lymphoma/patient/mycosis-fungoides-treatment-pdq</a>. Accessed <MM/DD/YYYY>. [PMID: 26389317]</p><p id="CDR0000258022__AboutThis_16">Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in <a href="https://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>. Visuals Online is a collection of more than 3,000 scientific images.
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</p></div><div id="CDR0000258022__AboutThis_17"><h3>Disclaimer</h3><p id="CDR0000258022__AboutThis_18">The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the <a href="https://www.cancer.gov/about-cancer/managing-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Managing Cancer Care</a> page.</p></div><div id="CDR0000258022__AboutThis_19"><h3>Contact Us</h3><p id="CDR0000258022__AboutThis_20">More information about contacting us or receiving help with the Cancer.gov website can be found on our <a href="https://www.cancer.gov/contact" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Contact Us for Help</a> page. Questions can also be submitted to Cancer.gov through the website’s <a href="https://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">E-mail Us</a>.</p></div></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65878/?report=reader">PubReader</a></li><li><a href="/books/NBK65878/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK65878" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK65878" style="display:none" title="Cite this Page"><div class="bk_tt">PDQ Adult Treatment Editorial Board. Mycosis Fungoides (Including Sézary Syndrome) Treatment (PDQ®): Patient Version. 2022 Mar 25. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. <span class="bk_cite_avail"></span></div></div></li><li><a href="#" class="toggle-glossary-link" title="Enable/disable links to the glossary">Disable Glossary Links</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Version History</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter shutter_closed" title="Show/hide content" remembercollapsed="true" pgsec_name="version_history" id="Shutter"></a></div><div class="portlet_content" style="display: none;"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><span class="bk_col_itm">NBK65878.14</span> March 25, 2022 (Displayed Version)</li><li><span class="bk_col_itm"><a href="/books/NBK65878.13/">NBK65878.13</a></span> December 2, 2021</li><li><span class="bk_col_itm"><a href="/books/NBK65878.12/">NBK65878.12</a></span> August 27, 2021</li><li><span class="bk_col_itm"><a href="/books/NBK65878.11/">NBK65878.11</a></span> April 8, 2020</li><li><span class="bk_col_itm"><a href="/books/NBK65878.10/">NBK65878.10</a></span> November 15, 2019</li><li><span class="bk_col_itm"><a href="/books/NBK65878.9/">NBK65878.9</a></span> July 29, 2019</li><li><span class="bk_col_itm"><a href="/books/NBK65878.8/">NBK65878.8</a></span> May 17, 2019</li><li><span class="bk_col_itm"><a href="/books/NBK65878.7/">NBK65878.7</a></span> March 28, 2019</li><li><span class="bk_col_itm"><a href="/books/NBK65878.6/">NBK65878.6</a></span> September 7, 2017</li><li><span class="bk_col_itm"><a href="/books/NBK65878.5/">NBK65878.5</a></span> July 11, 2017</li><li><span class="bk_col_itm"><a href="/books/NBK65878.4/">NBK65878.4</a></span> June 16, 2017</li><li><span class="bk_col_itm"><a href="/books/NBK65878.3/">NBK65878.3</a></span> July 22, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK65878.2/">NBK65878.2</a></span> February 5, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK65878.1/">NBK65878.1</a></span> May 26, 2015</li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>In this Page</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="page-toc" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="#CDR0000258022__1" ref="log$=inpage&link_id=inpage">General Information About Mycosis Fungoides (Including Sézary Syndrome) </a></li><li><a href="#CDR0000258022__26" ref="log$=inpage&link_id=inpage">Stages of Mycosis Fungoides (Including Sézary Syndrome) </a></li><li><a href="#CDR0000258022__50" ref="log$=inpage&link_id=inpage">Treatment Option Overview</a></li><li><a href="#CDR0000258022__241" ref="log$=inpage&link_id=inpage">Treatment of Stage I and Stage II Mycosis Fungoides</a></li><li><a href="#CDR0000258022__242" ref="log$=inpage&link_id=inpage">Treatment of Stage III and Stage IV Mycosis Fungoides (Including Sézary Syndrome)</a></li><li><a href="#CDR0000258022__244" ref="log$=inpage&link_id=inpage">Treatment of Recurrent Mycosis Fungoides (Including Sézary Syndrome)</a></li><li><a href="#CDR0000258022__141" ref="log$=inpage&link_id=inpage">To Learn More About Mycosis Fungoides and Sézary Syndrome</a></li><li><a href="#CDR0000258022__AboutThis_1" ref="log$=inpage&link_id=inpage">About This PDQ Summary</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related publications</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="document-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65849/">Health Professional Version</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Similar articles in PubMed</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PBooksDiscovery_RA" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389388" ref="ordinalpos=1&linkpos=1&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Melanoma Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Melanoma Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Adult Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389197" ref="ordinalpos=1&linkpos=2&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Retinoblastoma Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Retinoblastoma Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Pediatric Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389499" ref="ordinalpos=1&linkpos=3&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Pheochromocytoma and Paraganglioma Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Pheochromocytoma and Paraganglioma Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Adult Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/31909939" ref="ordinalpos=1&linkpos=4&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Childhood Chordoma (PDQ®): Patient Version.</a><span 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