Transformed Mycosis Fungoides: Treatment Options

For most patients with transformed mycosis fungoides (MF), physicians utilize approaches that have been proven effective for others forms of aggressive T-cell lymphomas. A patient whose MF has transformed should be seen by a T-Cell lymphoma specialist to develop an individualized treatment plan. The U.S. Food and Drug Administration (FDA) has approved several therapies for the treatment of patients with transformed MF.

Therapeutic options for patients with transformed MF who have limited areas of skin involvement include:

• Mechlorethamine topical gel (e.g., Valchor)
• Local radiation
• Phototherapy
• Post-radiation maintenance therapy with oral agents such as bexarotene (Targretin), methotrexate (Trexall), or interferon

Patient with transformed MF involving multiple areas of the skin are usually treated with systemic therapy (treatment directed at the entire body), which include:

• Pralatrexate (Folotyn)
• Romidepsin (Istodax)
• Gemcitabine (Gemzar)
• Doxorubicin (Doxil)
• Brentuximab vedotin (Adcetris)

Patients with transformed MF in multiple areas may also benefit from an allogeneic stem cell transplant (in which patients receive stem cells from a donor) if it is determined that they are good candidates for this procedure.

Treatments under investigation for transformed MF include bortezomib (Velcade), everolimus (Afinitor), and lenalidomide (Revlimid). Other treatments include immunotherapy with genetically engineered T cells, which is being tested in early trials for patients with transformed MF. Some trials are investigating combinations of agents with and without stem cell transplant in patients with transformed MF. It is critical to remember that today’s scientific research is continuously evolving.

To learn more about treatments under investigation for transformed MF, download the Transformed Lymphomas Fact Sheet.