Chemotherapy is one of the main treatments for non-Hodgkin lymphoma (NHL).
Chemotherapy is the use of anti-cancer (cytotoxic) drugs to treat cancer. It is a systemic therapy that circulates throughout the body and destroys cancer cells, including those that may have broken away from the primary tumour.
Chemotherapy may be used:
Drugs, doses and schedules vary from person to person. Chemotherapy is usually given in cycles. The number of cycles and how much time in between them depends on the type, stage and grade of NHL a person has and the types of chemotherapy drugs being given.
The chemotherapy drugs that are used depend on the type, stage and grade of NHL being treated.
Single chemotherapy drugs are generally used for slow-growing (indolent) NHLs. The most common single chemotherapy drugs used to treat NHL are:
Combinations of chemotherapy drugs are usually used to treat NHLs. The most common chemotherapy combinations used to treat NHL are:
CHOP and CVP are usually given for 6–8 cycles, depending on the stage of the lymphoma and how it responds to treatment. A cycle is generally given every 21 days.
There are several other combinations of chemotherapy drugs that can be used to treat NHL. Different types of combinations may be used to treat certain types of NHL. Some other combinations of chemotherapy drugs that may be used include:
Sometimes a person's NHL recurs or relapses after being treated with chemotherapy or doesn't respond very well to initial chemotherapy treatment. In these cases, different chemotherapy drugs or more intensive chemotherapy may be given. This is sometimes referred to as salvage chemotherapy. Higher doses of drugs may be used or the schedule over which the drugs are given is shortened to make the chemotherapy more intense.
Some salvage chemotherapy regimens for NHL include:
Intrathecal chemotherapy is given directly into the cerebrospinal fluid that surrounds the brain and spinal cord through a lumbar puncture. Chemotherapy may also be given through a special device under the scalp called an Ommaya reservoir (intraventricular chemotherapy). These types of chemotherapy are given to people whose lymphoma has spread to the central nervous system (CNS). Sometimes such chemotherapy is given to certain people to prevent the spread of the lymphoma to the CNS (CNS prophylaxis).
CorticosteroidCorticosteroidAny steroid hormone that acts as an anti-inflammatory by reducing swelling and lowering the body’s immune response (the immune system’s reaction to the presence of foreign substances). drugs like prednisone are often given with chemotherapy to treat NHL.
Rituximab (Rituxan) is a biological therapy drug that is used to treat many different types of B-cell lymphomas. It may be added to chemotherapy combinations like CHOP (CHOP-R or R-CHOP), CVP (CVP-R or R-CVP), or given with single drugs like fludarabine (fludarabine-R).
For more detailed information on specific drugs, go to sources of drug information.