What are the treatment options for lymphoma?
The primary treatment options for lymphoma include chemotherapy, radiotherapy, bone marrow transplants (sometimes referred to as stem cell transplants), targeted therapies and monoclonal antibodies (immunotherapy). The type of treatment you receive will depend on a number of different considerations, such as the sub-type of lymphoma you have, its stage, your overall health and your treatment preferences. This page aims to give you a comprehensive overview of how lymphoma treatment works.
Types of lymphoma treatment
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Chemotherapy
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Radiotherapy
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Targeted therapies
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Immunotherapy
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Bone marrow transplant
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Chemotherapy for lymphoma
Chemotherapy uses a range of drugs to both kill and slow the growth of lymphoma cells. Typically, chemotherapy is the primary treatment for aggressive or advanced forms of lymphoma. In certain circumstances, chemotherapy drugs may be used in combination with other treatment methods such as antibody therapy, steroid therapy or radiotherapy.
Radiotherapy for lymphoma
Patients who receive radiotherapy for lymphoma will commonly receive external beam radiotherapy (EBRT).
Radiotherapy may be used to treat early-stage lymphomas (stage I or II). Radiotherapy and chemotherapy may be used together in a treatment often referred to as chemo-radiation.
Targeted therapy for lymphoma
Targeted therapies use specialised drugs to destroy specific proteins in lymphoma cells, while aiming leaving healthy cells intact. These drugs aim to stop lymphoma cells from repairing themselves when they get damaged.
Immunotherapy for lymphoma
Immunotherapy treatment harnesses your own immune system to destroy and slow the growth of lymphoma cells. Immunotherapy drugs may be combined with chemotherapy drugs, targeted therapies or used alone to treat lymphoma.
Bone marrow transplant for lymphoma
Bone marrow transplants, which are also referred to as stem cell transplants, replace a patient’s bone marrow with healthy stem cells that help stimulate the development of new, healthy bone marrow after the patient first receives high doses of chemotherapy, generally delivered intravenously, before the healthy stem cells are transplanted.
Bone marrow transplants are generally reserved for relapsed lymphoma.
Types of bone marrow transplants
There are two types of bone marrow transplants that you may receive for lymphoma:
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Allogenic transplants
This refers to bone marrow (stem cells) given by a donor, often a relative or sometimes a HLA matched unrelated donor.
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Autologous transplants
This is where your own stem cells are collected, then frozen (cryopreserved) and stored. Following the high dose chemotherapy these stem cells (i.e. your own stem cells) are then transfused into your bloodstream.
Treatment by stage of lymphoma
When you are diagnosed with lymphoma, your haematologist will develop your treatment plan as part of a multidisciplinary team based on the type of lymphoma you have and its stage.
You can find common treatment options for both types of lymphoma by stage below.
Hodgkin lymphoma
Early stage disease (Ann Arbor Stages I and II)
Early-stage Hodgkin lymphomas are typically treated, with two to four cycles of chemotherapy followed by radiotherapy.
Advanced stage disease (Ann Arbor Stages III and IV)
Treatment for stage IV Hodgkin usually involves six cycles of chemotherapy, occasionally followed by radiotherapy.
Non-Hodgkin lymphoma
Early stage disease (Ann Arbor Stages I and II)
Low grade, early-stage non-Hodgkin lymphoma is generally treated with radiotherapy although in some instances immunochemotherapy can either be given pre-radiotherapy (ie. Combined modality therapy) or instead of radiotherapy. For high grade, early-stage non-Hodgkin lymphoma (also known as limited stage high-grade NHL), your doctor will generally recommend immuno-chemotherapy +/- radiotherapy directed at the affected lymph nodes.
Advanced stage disease (Ann Arbor Stages III and IV)
Low grade, advanced-stage non-Hodgkin lymphoma can be managed with either: watch and wait, immunotherapy or immuno-chemotherapy. Stage III and IV (advanced stage) high-grade non-Hodgkin lymphoma is primarily treated with intensive immuno-chemotherapy for six to eight cycles of therapy using a combination of chemotherapy drugs and in many cases immunotherapy. Your doctor may also recommend a bone marrow transplant following your course of primary immuno-chemotherapy, although bone marrow transplants are often reserved for relapsed disease.
References
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