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Treatments and drugs
By Mayo Clinic staffSeveral factors affect the choice of treatment, including the type and stage of your lymphoma, your age, and your overall medical condition. The main treatment options include:
- Chemotherapy. Doctors use a combination of drugs — given orally or by injection — against fast-growing cancer cells. This combined treatment approach is used for intermediate- and high-grade lymphomas and advanced stages of low-grade lymphomas. A single drug may be used if you have a low-grade type of the disease.
- Radiation. High doses of radiation kill cancerous cells and shrink tumors. This treatment is for early stages of low-grade lymphomas. Sometimes, it's used along with chemotherapy on intermediate-grade tumors or to treat specific sites, such as the brain.
- Stem cell transplantation. Lymphomas tend to be sensitive to chemotherapy. However, if lymphoma recurs, higher doses of chemotherapy may be necessary to treat the disease. The amount of chemotherapy that can be given is limited because of the damage chemotherapy does to your bone marrow. In order to avoid this serious side effect, healthy stem cells — those capable of producing new cells — are taken from your blood or bone marrow and frozen. After you undergo very high doses of chemotherapy to kill the lymphoma, the healthy stem cells are thawed and injected back into your body. This treatment is used primarily to treat intermediate- or high-grade lymphomas that relapse after initial, successful treatment.
- Observation. If your lymphoma appears to be slow growing, a wait and see approach may be an option. Slowly growing lymphomas with few symptoms may not require treatment for a year or more.
- Biotherapy. Rituximab (Rituxan) is approved by the Food and Drug Administration (FDA) for the treatment of B cell non-Hodgkin's lymphoma. Rituximab is a type of monoclonal antibody that helps the immune system specifically target and destroy cancer cells. Rituximab is frequently used in combination with chemotherapy. It's also sometimes given in tandem with radioimmunotherapy.
- Radioimmunotherapy. Two radioimmunotherapy drugs — ibritumomab (Zevalin) and tositumomab (Bexxar) — are currently FDA-approved. Radioimmunotherapy uses monoclonal antibodies combined with radioactive isotopes. The antibodies attach themselves to the cancer cells, while the added radiation helps destroy the cancer cells. Radioimmunotherapy is generally well tolerated; however, serious side effects, including reduced blood cell counts, hemorrhage and life-threatening infections, are possible with these medications. That's why the FDA has approved their use only after other treatments have failed.
- Interferon therapy. Interferons are proteins that occur naturally in your body to help fight viral infection and regulate your immune system. Some research suggests that genetically engineered interferon can slow or stop the progression of some types of non-Hodgkin's lymphomas. More studies are needed to determine whether interferon medications are an effective treatment for this disease.
