Objectives: To evaluate the activity and safety of hydralazine and valproate (Transkrip) in cutaneous T-cell lymphoma (CTCL).Methods: Previously untreated and progressive/refractory CTCL patients received hydralazine at 83mg or 182mg/day for slow and rapid acetylators respectively plus magnesium valproate at a total dose of 30mg/Kg t.i.d daily in continuous 28-day cycles in this phase II study. The primary objective was overall response rate (ORR) measured by the modified severity weighted assessment tool (m-SWAT), secondary end-points were time to response (TTR), time to progression (TTP), duration of response (DOR), progression-free survival (PFS), overall survival (OS) and safety.Results: Fourteen patients were enrolled (7 untreated and 7 pretreated). ORR was 71% with 50% complete and 21% partial. Two had stable disease and two progressed. At a median follow-up of 36months (5-52), median TTR was 2months (1-4); median DOR was 28months (5-45); median PFS 36 and not reached for OS. There were no differences in median TTR, DOR, and PFS between treated and pretreated patients. Pruritus relieve was complete in 13 out of 14 patients. No grade 3 or 4 toxicities were observed.Conclusion: The combination of hydralazine and valproate is safe, very well tolerated and effective in CTCL.