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Lymphoma: Treatments

Hodgkin's Lymphoma

Hodgkin's lymphoma can be cured in about 85% of patients, making it one of the most curable forms of cancer.

Treatments for Hodgkin's lymphoma include radiation therapy, chemotherapy or a combination of both treatments.

If the Hodgkin's lymphoma cells are just in one area, radiation therapy may be the only treatment used. If the Hodgkin's lymphoma has spread beyond one area but isn’t widespread through the body, the doctor may decide to use radiation, chemotherapy or both. If the Hodgkin's lymphoma is widespread and the patient has fever or weight loss, chemotherapy may be the only treatment used. 

Radiation

  • Uses high-energy rays to kill lymphoma cells in one area of the body.
  • Rays are usually also directed at nearby areas to kill any lymphoma cells that were not found.
  • Treatment usually takes place 5 days a week for several weeks.
  • Treatment may also affect nearby normal cells and cause side effects.

Chemotherapy

  • Uses drugs to kill lymphoma cells throughout the body.
  • Drugs may be injected, given through an IV tube or taken by mouth.
  • Often several drugs are used together.
  • Usually several cycles are given, and each cycle usually lasts about 3-4 weeks, with periods of treatment and rest.
  • May cause side effects by harming some normal cells.

In some patients, Hodgkin's lymphoma may come back, called a recurrence or relapse. The doctor will treat these patients again with chemotherapy. The treatment often gives patients very long disease-free periods. Many patients with Hodgkin's lymphoma are cured after they finish their treatment. The success of treatment depends on how advanced the disease is and the age of the patient.

Hodgkin's lymphoma makes it harder for the body’s immune system to fight off infection. Chemotherapy and radiation can add to the problem since they also lower the immune system’s ability to fight infection. Sometimes, very high doses of chemotherapy may be needed to treat Hodgkin's lymphoma. But chemotherapy also kills normal blood-forming cells in the marrow. Blood-forming cells are needed to help make sure healthy blood cells recover after treatment.

Hodgkin's lymphoma patients who have high-dose chemotherapy may need an autologous stem cell transplant. Autologous means the patient’s own cells are used for the transplant. Before chemotherapy begins, stem cells are taken from the patient’s blood or marrow and stored. They are injected back into the patient after treatment when chemotherapy ends. The goal of the autologous stem cell transplant is to restore the body’s ability to make normal blood cells after high-dose chemotherapy.

Non-Hodgkin's Lymphoma

There are several factors to take into account for a treatment plan for non-Hodgkin's lymphoma:

  • The type of non-Hodgkin's lymphoma
  • How fast the lymphoma is growing
  • The stage of the disease
  • The type of lymphocyte affected (T-cells or B-cells)
  • Whether parts of the body besides the lymph nodes such as the brain, liver or bones are involved
  • The patient’s age and other medical problems, if any
  • The patient’s symptoms, such as fever, sweating and weight loss

In most cases, a patient begins treatment for non-Hodgkin's lymphoma right away, but when a patient has non-Hodgkin's lymphoma that is widespread throughout the body and is slow-growing, the doctor may recommend “watch and wait.” This means regular follow-up visits to check the patient’s health. If there are signs the lymphoma is starting to grow, then treatment will begin. "Watch and wait" allows the patient to avoid the side effects of therapy until treatment is needed.

The goal of treatment for non-Hodgkin's lymphoma is to kill as many lymphoma cells as possible and to get rid of all symptoms of the disease for an extended period of time, called a remission.

Patients with slow-growing non-Hodgkin's lymphoma a
re often treated with one, two or three drugs and may have a return of their disease after treatment, at which point more treatment may be needed. These patients often have a series of remissions that last a number of years. During remissions, patients are able to continue their usual activities.

Treatment for non-Hodgkin's lymphoma may include radiation, chemotherapy and other treatments.

Radiation

  • Uses high-energy rays to kill lymphoma cells in one area of the body.
  • Rays are usually also directed at nearby areas to kill any lymphoma cells that were not found.
  • Treatment usually takes place 5 days a week for several weeks.
  • Treatment may also affect nearby normal cells and cause side effects.

Radiation is not usually the only treatment for non-Hodgkin's lymphoma because the lymphoma cells are likely to be in many areas of the body.

Chemotherapy

  • Uses drugs to kill lymphoma cells throughout the body.
  • Drugs may be injected, given through an IV tube or taken by mouth.
  • Often several drugs are used together.
  • Usually several cycles are given, and each cycle usually lasts about 3-4 weeks, with periods of treatment and rest.
  • May cause side effects by harming some normal cells.

Patients with faster-growing non-Hodgkin's lymphomas often need to be treated with four or more drugs. This treatment can be very effective, and in some cases can cure the non-Hodgkin's lymphoma.

Chemotherapy drugs are usually given in cycles that last for three to four weeks. The treatment may be from six to 12 cycles, lasting from about 6-12 months.

Treatment for non-Hodgkin's lymphoma is done on an outpatient basis for many patients. Sometimes a patient has to stay in the hospital for short periods of time to receive antibiotics in order to fight infection.

Sometimes therapy causes red cells, white cells or platelets to drop to very low levels. The use of drugs called blood cell growth factors may be needed. A blood transfusion is also given if needed. 

Other therapies for non-Hodgkin's lymphoma might include:

Immunotherapy: This treatment uses immune cells and antibodies made in the lab to kill cancer cells.

  • Monoclonal antibody therapy: One type of immunotherapy. Monoclonal antibodies are biologic therapies that act specifically against a particular antigen. Using new technologies, scientists can now produce large amounts of antibody that can be directed to a single target on the cell’s surface. Monoclonal antibodies have been developed to help combat specific cancers, including some forms of non-Hodgkin's lymphoma.
  • Radioimmunotherapy: This treatment uses antibodies to carry a radioactive substance to the lymphoma cells. The radiation helps kill the lymphoma cells and leaves most normal cells alone.

Stem cell transplant: This treatment is used for some patients who still have non-Hodgkin's lymphoma even after having therapy. These patients need high-dose chemotherapy to treat their non-Hodgkin's lymphoma, but chemotherapy also kills normal blood-forming cells in the marrow, called stem cells. These stem cells are needed to make new, healthy blood cells after treatment.

  • Donated stem cells, called allogeneic transplant, or the patient’s own stem cells, called autologous transplant, are injected into the patient’s bloodstream after chemotherapy. The transplanted stem cells go to the marrow and help start a new supply of red cells, white cells and platelets.
  • In autologous stem cell transplant, a patient’s own stem cells are collected before chemotherapy and are reinjected into the patient after chemotherapy ends.
  • High-dose chemotherapy plus autologous stem cell transplant is a cure for aggressive relapsed or refractory lymphomas, but not for slow-growing lymphomas.
Last updated: 5/26/2010 11:18:15 AM