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The following are treatment options for recurrent aggressive non-Hodgkin lymphoma (NHL). This is also called a relapse. Usually, when lymphomas recur, they tend to come back in the same part of the body they started in. NHL may also recur in another part of the body. Aggressive lymphomas can recur even though they may have been sensitive to chemotherapy initially.
The types of treatments given are based on the unique needs of the person with lymphoma. Treatment options depend on such factors as:
Chemotherapy is given for recurrent or relapsed aggressive NHL. People are often given different kinds of chemotherapy drugs than the ones used initially. This usually involves a combination of drugs and more intensive treatment than was given initially. These may be referred to salvage chemotherapy regimens.
In many cases, recurrent or relapsed lymphoma will respond to new kinds of chemotherapy drugs, but it will rarely be cured. If a remissionremissionA decrease in or the disappearance of signs and symptoms of a disease (such as cancer). occurs after this second type of treatment, then a stem cell transplant may be recommended, especially if the lymphoma is still sensitive to chemotherapy. People with chemotherapy-responsive lymphoma have a better response to treatment with a stem cell transplant than those who are not responsive to chemotherapy.
A stem cell transplant may also be used to treat people with an indolent lymphoma that has changed (transformed) into an aggressive one.
Biological therapy may be offered for recurrent or relapsed aggressive NHL. Rituximab (Rituxan) is used most often for recurrent or relapsed B-cell lymphomas. It is given with combination chemotherapy.
Other biological therapy drugs, like ibritumomab (Zevalin), may also be used for B-cell lymphomas if chemotherapy and rituximab no longer seem to be working. Ibritumomab may be tried when an indolent lymphoma has changed (transformed) into an aggressive B-cell lymphoma and other therapies aren't working (the lymphoma is refractory to treatment).
People with recurrent or relapsed NHL may be offered the opportunity to participate in clinical trials. For more information, go to clinical trials.
The Canadian Cancer Society is actively lobbying the federal government to establish a national caregivers strategy to ensure there is more financial support for this important group of people.