Non-Hodgkin's Lymphoma

What are the treatments for the disease?

Lymphoma tends to be a total-body or systemic disease. So chemotherapy is the mainstay of treatment. The exact medicines, doses, duration of treatment, and combination with radiation therapy depend on the type of lymphoma.

High-grade lymphomas are treated with intensive high-dose intravenous (IV) chemotherapy. This approach is sometimes used for intermediate-grade lymphomas, too. Methotrexate, vincristine, vinblastine, etoposide (VP-16), and many other medicines are used. They are given in cycles for several weeks to several months. People are usually treated as outpatients unless other medical problems arise.

Low-grade lymphomas are treated when problems occur. The problems usually result from long-term treatment with immune therapy or low-dose chemotherapy medicines, such as cladribine (2-cda) or fludarabine. It's not known for sure whether this disease can be cured with medical treatment. The problem has been that the disease recurs after treatment, and the recurrence is harder to treat. Lymphoma may need to be treated with high-dose chemotherapy, total-body or total-lymph node radiation, and bone marrow transplantation.

Surgery is sometimes needed, but it is not considered a cure. Surgery can relieve problems caused by lymphoma. These include bowel obstruction, blocked blood vessels, and spinal cord compression.

Radiation therapy is used to ease symptoms and as a potential cure. Early-stage lymphoma limited to one lymph node area can sometimes be cured with radiation alone. But radiation therapy alone does not work well on more advanced lymphomas. Radiation therapy is also used to shrink bothersome lymph nodes or other masses.

Immune therapy is giving a person manufactured proteins and other substances often made by a normal immune system. It's a new and evolving kind of treatment. Interferons, interleukins, monoclonal antibodies, immune toxins, or radiolabeled immune proteins may be given.

What are the side effects of the treatments?

Chemotherapy can cause:

Radiation therapy can cause:

These treatments also can cause damage to:

A combination of radiation and chemotherapy can increase the severity of side effects.

High-dose chemotherapy and bone marrow transplantation are highly toxic and risky treatments. Sometimes the transplanted immune system attacks the person's normal cells and tissue. There can be mild problems with skin rash and diarrhea. There can also be major organ failure, causing death.

What happens after treatment for the disease?

Some low-grade lymphomas are treated only to lessen the symptoms. Treatment is stopped when the benefits do not outweigh the side effects. Some people may need to be treated periodically. Other lymphomas are considered curable. Some high-grade lymphomas have a 60% to 80% cure rate.

How is the disease monitored?

Hodgkin's disease sometimes recurs. For this reason, the healthcare provider will monitor a person for several years by doing:

Any new or worsening symptoms should be reported to the healthcare provider.